Si-Yue Li, Li Qin, Lei Zhang, Xing-Bo Song, Yi Zhou, Juan Zhou, Xiao-Jun Lu, Ju Cao, Lan-Lan Wang, Jun Wang, Bin-Wu Ying
Med Sci Monit 2011; 17(10): PH75-80
Background: Lamivudine (LMV), as the preferred oral drug for use in treatment of HBV, always results in development of resistance mutations after long-term treatment. In this study we investigated chronic hepatitis B (CHB) patients in southern China to determine whether different HBV genotypes affect the incidence of LMV resistance mutations.
Material/Methods: The study recruited 185 CHB patients living in southern China. Enzyme-linked immunosorbent assay was used to test for HBV serological markers, and HBV DNA was quantified by real-time PCR. Sequencing was performed to detect HBV genotypes and mutations.
Results: There were 49.19% (91/185) CHB patients with HBV resistant to LMV. Only 2 genotypes were found: B and C; 62.16% (115/185) of patients were infected with genotype B HBV and 37.84% (70/185) of patients were infected with genotype C HBV. The incidence rate of LMV resistance was not significantly different between genotype B and C (49.57% vs. 48.57%, P>0.05). For the mean age and sex ratio, no significant difference was found. The pattern of rtM204I alone was predominantly observed (36.26%, 33/91), followed by rtM204V+rtL180M (23.08%, 21/91). The overall incidence rate of rtM204I mutation in genotype B (45.61%, 26/57) was more frequent than that in genotype C (20.59%, 7/34) (45.61% vs. 20.59%, P<0.05), but the incidence rate of other mutation patterns was not significantly different between genotypes B and C.
Conclusions: Our results emphasize that a LMV resistance test before treatment is of great importance in rational and optimal CHB therapy.
Keywords: Lamivudine - therapeutic use, Logistic Models, Humans, Hepatitis B virus - genetics, Hepatitis B - drug therapy, Genotype, Enzyme-Linked Immunosorbent Assay, Drug Resistance, Viral - genetics, China, Antiviral Agents - therapeutic use, Mutation - genetics, Odds Ratio, Real-Time Polymerase Chain Reaction