Antiviral therapy against chronic hepatitis B in Brazil: high rates of lamivudine resistance mutations and correlation with HBV genotypes
Mem. Inst. Oswaldo Cruz
;
107(3): 317-325, May 2012. graf, tab
Article
Dans Anglais
| LILACS
| ID: lil-624012
ABSTRACT
The effectiveness of antiviral treatments of chronic hepatitis B has been poorly studied in Brazil. Here, hepatitis B virus (HBV) DNA positivity, drug resistance mutations and their association with HBV genotypes were evaluated in chronically HBV-infected patients under different drug regimens in Brazil. The study involved 129 patients under interferon or nucleos(t)ide analogue therapy for a median treatment time of 12 months. One hundred and five (81%) of these patients were treated with lamivudine (LAM), either in monotherapy or in combination with newer drugs, such as entecavir (ETV) or tenofovir (TDF). High (37.5-100%) rates of HBV DNA positivity were observed with all but one drug regimen (LAM + ETV). However, patients that were treated with ETV alone, TDF alone or with LAM combination therapies had a mean viral load that was 3-4 log lower than patients treated with LAM monotherapy. Of the patients treated with LAM, 47% developed resistance mutations. HBV genotypes A (59.1%), D (30.3%) and F (9.1%) were found. There was no association between the presence of LAM resistance mutations and genotypes, HBeAg status or treatment duration. Nevertheless, the rtM204V mutation was observed more frequently (12/13, 92%) in genotype A than in the others (p = 0.023). Six out of nine isolates that contained the rtM204I mutation belonged to genotype D and half of them displayed a single mutation. Genotype D isolates with the rtM204V variant preferentially displayed a triple mutation, while genotype A preferentially displayed a double mutation (p = 0.04).
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Antiviraux
/
Virus de l'hépatite B
/
Lamivudine
/
Hépatite B chronique
/
Résistance virale aux médicaments
/
Mutation
Type d'étude:
Étude observationnelle
/
Étude de prévalence
/
Facteurs de risque
Limites du sujet:
Adolescent
/
Adulte
/
Adulte très âgé
/
Femelle
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Mem. Inst. Oswaldo Cruz
Thème du journal:
Médecine tropicale
/
Parasitologie
Année:
2012
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Instituto Oswaldo Cruz-Fiocruz/BR
/
Laboratório Central de Saúde Pública Noel Nutels/BR
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