Predominance of pre-S1 mutated hepatitis B virus in a patient following treatment with adefovir dipivoxil.
A liver transplant recipient reinfected with a lamivudine-resistant mixed wild-type/pre-S1-deleted hepatitis B virus (HBV) strain and rescued with adefovir dipivoxil was still HBV DNA positive after more than 1 year of therapy. Analysis of serum HBV DNA, amplified by polymerase chain reaction and directly sequenced by dideoxy nucleotide chain-termination method, showed that adefovir inhibited the wild type, but not the pre-S1-deleted HBV. Predominance of the pre-S1-deleted strain over wild type after adefovir treatment suggests that either adefovir inhibited the wild type more effectively or the pre-S1 mutant replicates more efficiently. The normality of liver condition confirms that to exert its pathogenic effect, the pre-S1-deleted strain requires the presence of wild-type virus.
Villa
Erica
E
Department of Internal Medicine, University of Modena and Reggio Emilia, Modena, Italy. villa.erica@unimo.it
Boarino
Valentina
V
Grottola
Antonella
A
Gelmini
Roberta
R
Lama
Nicole G
NG
D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D017353:Gene Deletion; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics* / Q000502:physiology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009154:Mutation; D063065:Organophosphonates; D011498:Protein Precursors / Q000235:genetics*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D016879:Salvage Therapy
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D063065:Organophosphonates; D011498:Protein Precursors; D018894:Reverse Transcriptase Inhibitors; C050806:presurface protein 1, hepatitis B surface antigen; D019259:Lamivudine; D000225:Adenine; C106812:adefovir dipivoxil