Lamivudine resistance in naïve chronic hepatitis B patients

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.