Lamivudine-resistant HBV strain rtM204V/I in acute hepatitis B

详细信息    查看全文

• 作者：Nicola Coppola ; Gilda Tonziello ; Piero Colombatto ; Mariantonietta Pisaturo ; Vincenzo Messina ; Francesco Moriconi ; Loredana Alessio ; Caterina Sagnelli ; Daniela Cavallone ; Maurizia Brunetto ; Evangelista Sagnelli
• 关键词：Acute hepatitis B ; Resistance to nucleos(t)ide analogues ; Mutant HBV strains ; Lamivudine ; rtM204V ; rtM204I
• 刊名：Journal of Infection
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：67
• 期：4
• 页码：322-328
• 全文大小：349 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Summary

Aims

To detect HBV rtM204V/I lamivudine-resistant strains in serum of patients with acute hepatitis B and to assess their biological and clinical significance.

Methods

Eighty HBV DNA-positive patients with symptomatic acute hepatitis B observed from 1999 to 2010 were enrolled. A plasma sample obtained at the first observation was tested for HBV mutants in the polymerase region by direct sequencing; the antiviral drug-resistant rtM204V/I mutations, the most frequent HBV mutants in Italy, were also sought by the more sensitive allele-specific polymerase chain reaction (PCR).

Results

No HBV mutation associated with resistance to nucleos(t)ide analogues was identified by direct sequencing, whereas allele-specific PCR identified HBV strains carrying the substitution rtM204V/I in 11 (13.7 % ) patients. Compared with those with the HBV wild strain, patients with rtM204V/I more frequently showed severe acute hepatitis B (36.4 % vs 8.7 % ; p?<?0.05) and lower values of serum HBV DNA (1.77?¡Á?10⁶?¡À?4.76?¡Á?10⁶ vs. 1.68?¡Á?10⁸?¡À?5.46?¡Á?10⁸). In addition, a multivariate analysis identified the presence of a pre-existing HCV chronic infection as independently associated with severe acute hepatitis B (p?<?0.05).

Conclusions

HBV rtM204V/I lamivudine-resistant strains were detected in serum of 11 (13.7 % ) patients with acute hepatitis B by allele-specific polymerase chain reaction. The frequent association of rtM204V/I with a more severe acute hepatitis B and with a lower viral load may?suggest that greater and/or more prolonged immune pressure might have induced their selection.