In:
Intervirology, S. Karger AG, Vol. 49, No. 5 ( 2006), p. 274-280
Abstract:
〈 i 〉 Objective: 〈 /i 〉 The aim of this study was to predict breakthrough hepatitis and analyze the dynamics of lamivudine-resistant hepatitis B virus in patients treated with lamivudine. 〈 i 〉 Methods: 〈 /i 〉 Fifty-five chronic hepatitis B patients treated with lamivudine were included. The emergence of YMDD motif mutants was detected by peptide nucleic acid (PNA) mediated PCR clamping with a detection limit of 10 〈 sup 〉 1 〈 /sup 〉 YMDD mutants. We then performed a semiquantitative PCR assay of subjects in whom YMDD mutants were detected. This assay detects 10 〈 sup 〉 2.7 〈 /sup 〉 –10 〈 sup 〉 7.7 〈 /sup 〉 copies of mutant virus per 1 ml of serum. 〈 i 〉 Results: 〈 /i 〉 YMDD mutants were detected in 28 (51%) of the 55 patients. Eight patients stopped medication before viral breakthrough. YMDD mutants appeared transiently despite the continuance of lamivudine therapy in 12 patients. In all 8 patients with breakthrough hepatitis, the quantities of YMDD mutants ranged from 10 〈 sup 〉 2.7 〈 /sup 〉 –10 〈 sup 〉 4.7 〈 /sup 〉 copies/ml in the two to three months before clinical breakthrough. In contrast, in 12 patients without viral breakthrough, there were always less than 10 〈 sup 〉 2.7 〈 /sup 〉 copies/ml YMDD mutants. 〈 i 〉 Conclusions: 〈 /i 〉 Lamivudine-resistant viruses sometimes disappear even during lamivudine administration. Our sensitive quantitative assay proved useful for early detection of YMDD mutants and a threshold of 10 〈 sup 〉 2.7 〈 /sup 〉 copies/ml is suggested for predicting viral breakthrough.
Type of Medium:
Online Resource
ISSN:
0300-5526
,
1423-0100
Language:
English
Publisher:
S. Karger AG
Publication Date:
2006
detail.hit.zdb_id:
1482863-7
SSG:
12
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