Evaluation of anti-HBV drug resistant mutations among patients with acute symptomatic hepatitis B in the United States
| Autor: | Prashant V. Krishnan, Anne Kizy, Lynne Shetron-Rama, Andrea Snow-Lampart, Dwayne Baxa, Stuart C Gordon, Alicia Golembieski, Brandi J. Chappell, Ashish D. Thekdi, Omar Sharif, John Jovanovich, Katyna Borroto-Esoda |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male HBsAg Guanine Genotype Population Organophosphonates Drug resistance medicine.disease_cause Antiviral Agents Cohort Studies Drug Resistance Viral medicine Humans education Retrospective Studies Hepatitis B virus education.field_of_study Hepatology business.industry Adenine Sequence Analysis DNA Entecavir Hepatitis B medicine.disease Virology United States digestive system diseases Cross-Sectional Studies Lamivudine Acute Disease Mutation Female business Viral load medicine.drug |
| Zdroj: | Journal of Hepatology. 58:212-216 |
| ISSN: | 0168-8278 |
| Popis: | Background & Aims: Reported HBV drug resistance mutations among previously untreated patients with chronic hepatitis B are variable. Whether resistant HBV strains are transmitted in the acute setting is uncertain. We sought to document the presence of antiviral resistance (AVR) mutations in patients with acute HBV (AHB) infection. Methods: AHB infection was defined by HBsAg/IgM anti-HBc positivity, ALT>10X ULN and compatible clinical history. The TRUGENE HBV kit was used to perform genotyping and direct sequencing of the viral polymerase. INNO-LiPA HBV DRv2 and DRv3 were used to detect AVR mutations. Clonal sequencing was conducted on selected specimens. Results: Twenty-three patients were evaluated (mean age, 43 years; 54% male; 39% African American, 39% Caucasian, 13% Hispanic and 4% Asian). The mean peak ALT was 1554.2 IU/L and mean peak total serum bilirubin was 12 mg/dl. The HBV DNA median viral load (N = 15) was 5.14 log10 IU/ml. Nineteen patients were genotype A, and 1 each were genotype C, D, E and G. HBV drug resistance mutations were not detected by direct sequencing or INNO-LiPA. Clonal sequencing was conducted on 192 clones isolated from three patients and showed rtA181T, rtM250V and rtS202G mutations at an overall frequency of 1.54%, 1.39%, and 1.67% respectively. Conclusions: We detected adefovir/lamivudine and entecavir relevant mutations in a minor population ( |
| Databáze: | OpenAIRE |
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