Frequency and Mutation Patterns of Resistance in Patients with Chronic Hepatitis B Infection Treated with Nucleos(t)ide Analogues in Add-On and Switch Strategies

BACKGROUNDTreatment for chronic hepatitis B (CHB) has improved over the last 10 years mainly due to the development of effective oral antiviral agents [nucleoside/nucleotide analogs (NUCs)]. OBJECTIVESThe aim of the present study is to identify the frequency and major patterns of resistance to the h...

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Published in:Hepatitis monthly 2011-10, Vol.11 (10), p.835-842
Main Authors: Sayan, Murat, Cetin Akhan, Sila, Senturk, Omer
Format: Article
Language:English
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Summary:BACKGROUNDTreatment for chronic hepatitis B (CHB) has improved over the last 10 years mainly due to the development of effective oral antiviral agents [nucleoside/nucleotide analogs (NUCs)]. OBJECTIVESThe aim of the present study is to identify the frequency and major patterns of resistance to the hepatitis B virus (HBV) in a Turkish population of CHB patients treated with NUCs using add-on and switch therapy strategies. PATIENTS AND METHODSThe investigation involved a total of 194 patients (88 were treated using add-on therapy, and 106 were treated using switch therapy). We analyzed the HBV polymerase gene by amplification and direct sequencing procedures. RESULTSPrimary drug-resistance mutations were detected in 84 patients (43%; 42 in add-on therapy, and 42 in switch therapy) taking lamivudine (LAM), 10 patients (5%; 6 in add-on therapy, and 4 in switch therapy) taking entecavir (ETV), and 16 patients (8%; 8 in add-on therapy, and 8 in switch therapy) taking adefovir (ADV). The most common LAM and ETV resistance mutations were rtM204I/V, rtL180M and rtT184A/I/S, respectively, while rtA181T/V and rtN236T substitutions were the most frequently observed ADV resistance mutations. CONCLUSIONSPatients with CHB who developed NUC resistance were managed using 2 different rescue strategies. The frequency and mutation pattern of resistance were similar in patients treated with add-on and switch strategies. These findings may be helpful in the management of rescue strategies in LAM-resistant patients.
ISSN:1735-143X
1735-3408
DOI:10.5812/kowsar.1735143X.775