Research Article

Lamivudine resistance in naïve chronic hepatitis B patients

Volume: 41 Number: 3 September 30, 2019
EN

Lamivudine resistance in naïve chronic hepatitis B patients

Abstract

Objective: Prevalence of lamivudine resistance in treatment-naïve hepatitis B patients shows variation among populations. The present study aimed to determine the prevalence of lamivudine resistance in treatment-naïve chronic hepatitis B (CHB) patients followed in Turkish population.

Method: The study comprised 71 chronic hepatitis B patients that have never received treatment for chronic hepatitis B infection before (treatment-naïve). HBV DNA was detected quantitatively by real-time polymerase chain reaction (RT-PCR) method in serum samples collected from the patients. Sequence analysis and reverse hybridization by string method were used to determine Lamivudine motif mutants. Liver biopsy was performed in all patients. Serum samples collected were used to determine HBeAg and anti-HBeAb levels.

Results: Of the 71 patients participated in the study. Mutation was detected in a total of 8 patients and the prevalence was 11.3% (8/71). The prevalence of mutation was 8.3% (4/48) in HBeAg-negative patients and it was lower than HBeAg-positive patients, in whom the prevalence was 17% (4/23) (p=0.01). Comparing the patients with and without mutation in terms of demographic characteristics, ALT levels, HAI and fibrosis scores, no statistically significant difference was determined (p=0.29).

Conclusions: In the present study, the prevalence of mutation was 11.3% in treatment-naïve chronic hepatitis B patients.  Therefore, determining local prevalence for all populations and planning the treatment accordingly may prevent future complications and thereby enhance efficacy of treatment. Choosing drugs with low resistance profile and starting treatment considering this resistance.

Keywords

References

  1. Referans1) Heo J, Cho M, Kim HH, Shin YM, Jang HJ, Park HK, Kim CM, Kim GH, Kang DH, Song GA, Yang US. Detection of YMDD motif mutants by oligonucleotide chips in lamivudine-untreated patients with chronic hepatitis B virus infection. J Korean Med Sci. 2004 ;19:541–5.
  2. Referans2). Lok ASF, McMahon BJ. Chronic hepatitis B. Hepatology 2007 feb;45; 507-539. Referans3) Tacke F, Gehrke C, Luedde T, Heim A, Manns MP, Trautwein C. Basal core promoter and precore mutations in the hepatitis B virus genome enhance replication efficacy of Lamivu-dine-resistant mutants. J Virol. 2004 Aug;78(16):8524-35.
  3. Referans4) Tassopoulos NC, Volpes R, Pastore G, Heathcote J, Buti M, Goldin RD, Hawley S, Barber J, Condreay L, Gray DF. Efficacy of lamivudine in patients with hepatitis B e antigen-negative/hepatitis B virus DNA-positive (precore mutant) chronic hepatitis B. Lamivudine Precore Mutant Study Group. Hepatology. 1999 Mar;29(3):889-96.
  4. Referans5) Chayama K, Suzuki Y, Kobayashi M, Tsubota A, Hashimoto M, Miyano Y, et al. Emergence and takeover of YMDD motif mutant hepatitis B virus during long-term lamivudine therapy and retakeover by wild type after cessation o f therapy. Hepatology 1998: 1711-27.
  5. Referans6) Allen MI, Gauthier J, DesLauriers M, Bourne EJ, Carrick KM, Baldanti F, et al. Tw o sensitive PCR-based methods for detection of hepatitis B virus variants associated with reduced susceptibility to lamivudine. J Clin Microbiol 1999 oct: 3338—47., 37.
  6. Referans7) Kirishima T, Okanoue T, Daimon Y, Itoh Y, Nakamura H, Morita A, et al. Detection of YMDD mutant using a novel sensitive method in chronic liver disease type B patients before and during lamivudine treatment. J Hepatol 2002; 37 :259—65.
  7. Referans8) Kobayashi S, Ide T, Sata M. Detection of YMDD motif mutations in some lamivudine-untreated asymptomatic hepatitis B virus carriers. J Hepatol 2001; 34: 584—6.
  8. Referans9) Kirishima T, Okanoue T, Daimon Y, Itoh Y, Nakamura H, Morita A, Toyama T, Minami M. Detection of YMDD mutant using a novel sensitive method in chronic liver disease type B patients before and during lamivudine treatment. J Hepatol. 2002; 37: 259–265.

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Publication Date

September 30, 2019

Submission Date

September 8, 2019

Acceptance Date

September 25, 2019

Published in Issue

Year 2019 Volume: 41 Number: 3

AMA
1.Altınkaya E. Lamivudine resistance in naïve chronic hepatitis B patients. CMJ. 2019;41(3):524-530. doi:10.7197/cmj.vi.617023