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

authors:

avatar Murat Sayan 1 , * , avatar Sila Cetin Akhan 2 , avatar Omer Senturk 2

University of Kocaeli, Faculty of Medicine, Clinical Laboratory, sayanmurat@hotmail.com, Turkey
University of Kocaeli, Faculty of Medicine, Department of Clinical Bacteriology and Infectious Diseases, Turkey
Hepatitis Monthly: Vol.11, issue 10; 835-842
article type: Research Article
received: March 7, 2011
accepted: September 14, 2011
DOI: https://doi.org/10.5812/kowsar.1735143X.775

how to cite: Sayan M, Cetin Akhan S, 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): 835-842. https://doi.org/10.5812/kowsar.1735143X.775.

Abstract

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.

  • Implication for health policy/practice/research/medical education:
    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.
  • Please cite this paper as:
    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

© 2011 Kowsar M.P.Co. All rights reserved.

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