Lamivudine therapy for Japanese patients with cirrhosis B.
OBJECTIVE
The aim of this study was to investigate the emergence of YMDD mutants in patients with chronic hepatitis B during lamivudine therapy and to compare the emergence patterns of YMDD mutants in cirrhotic and noncirrhotic patients.


METHODS
Eighteen cirrhotic and 37 noncirrhotic patients with chronic hepatitis B were studied. The emergence of YMDD mutants was determined before, as well as at 1, 3, 6, 9 and 12 months after treatment using a highly sensitive method based on polymerase chain reaction.


RESULTS
Although YMDD mutants were elicited early, the emergence of YMDD mutants was not always associated with breakthrough hepatitis. YMDD mutants appeared in cirrhotic and noncirrhotic patients: in 22 and 8% at 1 month, 13 and 21% at 3 months, 46 and 19% at 6 months, 30 and 19% at 9 months, and 83 and 27% at 12 months, respectively.


CONCLUSIONS
YMDD mutants emerge more frequently in cirrhotic than noncirrhotic patients during the early period on lamivudine treatment. The highly sensitive method may be useful for monitoring the development of YMDD mutants in patients with chronic hepatitis B during lamivudine therapy.
Okanoue
Takeshi
T
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medicine, Kamigyo-ku, Kyoto, 602-8566, Japan. tokanoue@sun.kpu-m.ac.jp
Mori
Kojiro
K
Kirishima
Toshihiko
T
Kunimoto
Koji
K
Yasui
Kohichiroh
K
Itoh
Yoshito
Y
Minami
Masahito
M
D006528:Carcinoma, Hepatocellular; D004279:DNA, Viral / Q000032:analysis; D004352:Drug Resistance, Microbial / Q000235:genetics*; D005355:Fibrosis / Q000188:drug therapy* / Q000209:etiology; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007564:Japan; D019259:Lamivudine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use
D004279:DNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine