AIM: Few cases of primary entecavir resistance in chronic hepatitis B patients have been reported to date. The serial profiling of the HBV polymerase gene mutations from a treatment-naive patient who developed drug resistance after 32 months of entecavir therapy is presented here. DESIGN: Serum samples were collected at multiple time points from before the start of therapy to virological and biochemical breakthrough. The evolution of the hepatitis B virus polymerase gene mutations was analysed with commercial line probe assay and pyrosequencing. RESULTS: Drug resistance mutation analysis by pyrosequencing revealed a two-step process in the selection of drug resistance. The patient had a good initial response to entecavir 0.5 mg/day. A partially resistant HBV strain first emerged as the predominant species from as early as 2 weeks. After a period of non-compliance to therapy, there was virological breakthrough, which resolved on restarting entecavir. Shortly after, there was secondary failure of entecavir therapy, caused by a new resistant strain carrying all three mutations required. CONCLUSION: In this patient, pre-existence of minor population of partially resistant viral strains and treatment non-compliance probably contributed to his development of primary entecavir resistance.
AIM: Few cases of primary entecavir resistance in chronic hepatitis Bpatients have been reported to date. The serial profiling of the HBV polymerase gene mutations from a treatment-naive patient who developed drug resistance after 32 months of entecavir therapy is presented here. DESIGN: Serum samples were collected at multiple time points from before the start of therapy to virological and biochemical breakthrough. The evolution of the hepatitis B virus polymerase gene mutations was analysed with commercial line probe assay and pyrosequencing. RESULTS: Drug resistance mutation analysis by pyrosequencing revealed a two-step process in the selection of drug resistance. The patient had a good initial response to entecavir 0.5 mg/day. A partially resistant HBV strain first emerged as the predominant species from as early as 2 weeks. After a period of non-compliance to therapy, there was virological breakthrough, which resolved on restarting entecavir. Shortly after, there was secondary failure of entecavir therapy, caused by a new resistant strain carrying all three mutations required. CONCLUSION: In this patient, pre-existence of minor population of partially resistant viral strains and treatment non-compliance probably contributed to his development of primary entecavir resistance.
Authors: Shigeru Kusumoto; Luca Arcaini; Xiaonan Hong; Jie Jin; Won Seog Kim; Yok Lam Kwong; Marion G Peters; Yasuhito Tanaka; Andrew D Zelenetz; Hiroshi Kuriki; Günter Fingerle-Rowson; Tina Nielsen; Eisuke Ueda; Hanna Piper-Lepoutre; Gila Sellam; Kensei Tobinai Journal: Blood Date: 2018-10-19 Impact factor: 22.113
Authors: Yang Wang; Shuang Liu; Y U Chen; Sujun Zheng; L I Zhou; Fengmin Lu; Zhongping Duan Journal: Exp Ther Med Date: 2016-04-06 Impact factor: 2.447
Authors: Yang Wang; Shuang Liu; Y U Chen; Sujun Zheng; L I Zhou; Tsen Hua; Shaofei Sui; Fengmin Lu; Zhongping Duan Journal: Exp Ther Med Date: 2015-11-12 Impact factor: 2.447