Lamivudine Resistance in Iranian Chronic Hepatitis B Patients

[摘要] Backgroundandobjectives:LamivudinetherapyforchronichepatitisB(CHB)isassociatedwithresistance.Thisstudyaimedtoanalyzetheresponse,theincidenceofLAMresistance,anddifferentviralmutationalpatternsofLamivudinetherapy.Studydesign:CHBpatients(n=31)whohadnotpreviouslyreceivedinterferonoranucleosideanalogue,receivedLamivudineoncedailyforaminimumofE12monthsandfollowed.AllpatientsweretestedforpresenceofmutationinYMDDmotifofviralpolymerasegeneattheendofthefirstyearoftreatment,andifindicatedinrisingalanineaminotransferase(ALT)orHBVDNAtiter.Polymerasechainreactionalongwithrestrictionfragmentlengthpolymorphism(PCR-RFLP)methodwasusedtodetectmutationsinYMDDmotif.Results:Themeanageofpatientswas45.2(SD13.5)years.Themeanfollow-upperiodofpatientswas45.5(21.9)months.Seventeenpatients(54.8%)hadmutations,and45.2%ofsubjectsweresensitivetoLAM.Meantimeofmutationdetectionaftertreatmentwas45.5(SD25.3)months.ThedistributionofYMDDstatuswas:32.3%YIDD,3.2%YSDD,12.9%YVDD,and6.5%YVDD/YIDD.Themeanage,pretreatmentHBeAgnegativity,andhighHBVDNAtiterattimeofmutationhadsignificantstatisticalassociationwithoccurrenceofYMDDmutants(PV=0.009,0.032,0.049),respectively.Conclusions:Lamivudine-resistantmutationiscommoninCHBpatients.Regardingdifferentmutantstrainsasidentifiedinthisstudy,isnecessaryfordevelopmoreusefultreatmentstrategies,especiallyinpatientswithoutYMDDmutationandhighHBVDNAtiter,analysisforpossiblenewmutantsshouldbeperformed.

[学科分类] 基础医学

[关键词] Chronic hepatitis B;Lamivudine;Lamivudine- resistant mutations