Prevalence of hepatitis B virus DNA polymerase mutations in treatment-naïve patients with chronic hepatitis B.

Abstract

BACKGROUND:

One of the most important factors in treatment failure using nucleos(t)ide analogues in chronic hepatitis B is anti-viral resistance. Primary drug resistance refers to amino acid changes in the hepatitis B virus polymerase/reverse transcriptase (rt) that result in reduced susceptibility to anti-viral agents. Pre-existing drug resistance mutations may occur in untreated patients and may affect their treatment outcomes.

AIM:

To determine the prevalence of hepatitis B DNA polymerase mutations in treatment-naïve patients.

METHODS:

We used a direct PCR sequencing test to detect DNA polymerase mutations in 472 consecutive treatment-naïve patients at two community gastroenterology clinics in Northern California.

RESULTS:

A majority of patients were Asians (>95%), had either genotype B or C (95%) and had no evidence of cirrhosis or liver cancer (94%). Mean age was 45 +/- 13 and mean hepatitis B virus DNA was 5.3 +/- 1.8 log(10) IU/mL. Most patients did not have any detectable mutations (82.4%). Some (16.7%) had mutations of unknown clinical significance (rtV207M/L/I) and only 4 patients had rtA181A/S, rtA194S or M250I.

CONCLUSIONS:

No rtM204V/I or rtN236T mutations were observed in our study. Less than 1% of our patients had mutations that can be associated with primary resistance to existing anti-viral therapies for hepatitis B virus.

• Authors: M H Nguyen, R T Garcia, H N Trinh, H A Nguyen, K K Nguyen, L H Nguyen, B Levitt
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 30 Issue 11-12 Pg. 1150-8 (Dec 01 2009) ISSN: 1365-2036 [Electronic] England
• PMID: 19785624 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• RNA-Directed DNA Polymerase
• DNA-Directed DNA Polymerase

Topics

• Adult
• Antiviral Agents (therapeutic use)
• Cross-Sectional Studies
• DNA-Directed DNA Polymerase (genetics)
• Female
• Genotype
• Hepatitis B virus (drug effects, genetics)
• Hepatitis B, Chronic (drug therapy, genetics, virology)
• Humans
• Male
• Middle Aged
• Mutation (genetics)
• Prevalence
• RNA-Directed DNA Polymerase (genetics)
• Treatment Outcome