Frequency and Mutation Patterns of Resistance in Patients with Chronic Hepatitis B Infection Treated with Nucleos(t)ide Analogs in Add-On and Switch Strategies
M, Cetin Akhan
O. Frequency and Mutation Patterns of Resistance in Patients with Chronic Hepatitis B Infection Treated with Nucleos(t)ide Analogs in Add-On and Switch Strategies,
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Background: Treatment 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)]. Objectives: The 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 Methods: The 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. Results: Primary 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. Conclusions: Patients 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.
Authors revealed of major drug resistance patterns and their frequencies in add-on and switch strategies in treatment of chronic hepatitis B virus. This article is an helpful for clinicians involved in the management of rescue strategies in lamivudine-resistant patients in chronic hepatitis B. Implication for health policy/practice/research/medical education:
Sayan M, Akhan SC, Senturk O. Frequency and Mutation Patterns of Resistance in Patients with Chronic Hepatitis B Infection Treated with Nucleos(t)ide Analogs in Add-On and Switch Strategies. Hepat Mon.2011;11(10):835-42. DOI: 10.5812/kowsar.1735143X.775 Please cite this paper as:
© 2011 Kowsar M.P.Co. All rights reserved.
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