BACKGROUND AND AIMS: Acute hepatitis caused by lamivudine (LMV)-resistant strains has not been reported, and the clinical impact of LMV-resistant strains on acute hepatitis is not known. The aim of this study was to investigate the molecular and clinical characteristics of patients with acute hepatitis B caused by LMV-resistant strains. METHODS: Forty-five patients with acute hepatitis B were studied. Hepatitis B virus (HBV) subgenotypes and LMV-resistance mutations were determined by direct sequencing of the preS and polymerase regions, respectively. RESULTS: HBV subgenotypes A2 (n = 18), B1 (n = 1), B2 (n = 3), B3 (n = 2), C1 (n = 1), C2 (n = 19) and C6 (n = 1) were detected in patients with acute hepatitis. LMV-resistance mutations were detected in two patients. LMV-resistance mutations (L180M, M204I) were detected in a patient with subgenotype C2 who had acute self-limited hepatitis. The other patient with LMV-resistance mutations (L180M, M204V) was infected with subgenotype A2 and had severe hepatitis. CONCLUSION: LMV-resistant strains are rare, but they are starting to be found in patients with acute hepatitis B. Surveillance for detecting drug-resistant HBV strains would be important for clinical practice.
BACKGROUND AND AIMS: Acute hepatitis caused by lamivudine (LMV)-resistant strains has not been reported, and the clinical impact of LMV-resistant strains on acute hepatitis is not known. The aim of this study was to investigate the molecular and clinical characteristics of patients with acute hepatitis B caused by LMV-resistant strains. METHODS: Forty-five patients with acute hepatitis B were studied. Hepatitis B virus (HBV) subgenotypes and LMV-resistance mutations were determined by direct sequencing of the preS and polymerase regions, respectively. RESULTS:HBV subgenotypes A2 (n = 18), B1 (n = 1), B2 (n = 3), B3 (n = 2), C1 (n = 1), C2 (n = 19) and C6 (n = 1) were detected in patients with acute hepatitis. LMV-resistance mutations were detected in two patients. LMV-resistance mutations (L180M, M204I) were detected in a patient with subgenotype C2 who had acute self-limited hepatitis. The other patient with LMV-resistance mutations (L180M, M204V) was infected with subgenotype A2 and had severe hepatitis. CONCLUSION:LMV-resistant strains are rare, but they are starting to be found in patients with acute hepatitis B. Surveillance for detecting drug-resistant HBV strains would be important for clinical practice.
Authors: Tongai G Maponga; Rachel Matteau Matsha; Sébastien Morin; Andrew Scheibe; Tracy Swan; Isabelle Andrieux-Meyer; C Wendy Spearman; Marina B Klein; Jürgen Kurt Rockstroh Journal: Hepatol Med Policy Date: 2017-04-20