Abstract:
:One hundred and thirty-one post-liver transplantation patients with chronic hepatitis B and failing lamivudine therapy with detectable serum hepatitis B virus (HBV) deoxyribonucleic acid by hybridization assays or > or =1 x 10(6) copies/mL by polymerase chain reaction, and elevated alanine transaminase levels despite continuous lamivudine, were enrolled in an open-label study of adefovir dipivoxil. The B and C domains of HBV polymerase were sequenced for baseline samples to determine the presence of lamivudine resistance mutations. The results showed that 98% of the samples had tyrosine-methionine-aspartate-aspartate (YMDD) mutations, indicating a strong correlation between the above clinical definition of lamivudine treatment failure and the presence of YMDD mutations. In addition to the rtM204V/I and the rtL180M mutations, the mutation rtV173L was identified in 19% of patients. Four major patterns of lamivudine-resistant HBV were identified: rtL180M + rtM204V (60%), rtV173L + rtL180M + rtM204V (19%), rtM204I (9%) and rtL180M + rtM204I (9%). Treatment with adefovir dipivoxil showed similar antiviral efficacy in patients with lamivudine-resistant virus from all four patterns.
journal_name
J Viral Hepatjournal_title
Journal of viral hepatitisauthors
Westland CE,Yang H,Delaney WE 4th,Wulfsohn M,Lama N,Gibbs CS,Miller MD,Fry J,Brosgart CL,Schiff ER,Xiong Sdoi
10.1111/j.1365-2893.2005.00578.xsubject
Has Abstractpub_date
2005-01-01 00:00:00pages
67-73issue
1eissn
1352-0504issn
1365-2893pii
JVH578journal_volume
12pub_type
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