title: [Emergence and clinical significance of YMDD and HBeAg-related mutations during lamivudine treatment].
abstract: OBJECTIVE
  To explore YMDD and HBeAg related mutations of hepatitis B virus and its clinical significance during lamivudine therapy.
  
  
  METHODS
  From sera of chronic hepatitis B patients with 9 - 30 months lamivudine therapy, signal-base mutations of YMDD motif, G1896A, A1814C, A1762T and G1764A were analyzed by gene chips technique.
  
  
  RESULTS
  In the 102 patients with 18 months in average of lamivudine treatment, 22 were found to have YMDD mutations, including 8 with YMDD and HBeAg related mutants. 3 of the 8 patients had G1896A mutant, 2 had A1814C and the remaining had G1896A + A1814C, A1762T and G1764A, A1762T and G1764A + G1896A. The former 5 patients and signal YMDD mutant patients were HBeAg positive, while the latter 3 with YMDD and HBeAg related multiple mutants were HBeAg negative. One of the three patients with multiple mutants who continued lamivudine treatment 3 months more reversed to YMDD wide-type HBV with accompanying positive HBeAg.
  
  
  CONCLUSIONS
  Mutant of YMDD associated with HBeAg related multiple mutations during lamivudine treatment may arise in patients with HBV DNA breakthrough and negative HBeAg. HBV DNA should be detected in the patients with HBeAg seroconversion to exclude the HBeAg related multiple mutations.
authors.affiliation: Deptartment of Infectious Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: De-ying
authors.initials: DY
authors.lastname: Tian
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Wang
authors.forename: Hong-yun
authors.initials: HY
authors.lastname: Chen
authors.forename: Ming-you
authors.initials: MY
authors.lastname: Xing
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Pei-hui
authors.initials: PH
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000328:Adult; D020816:Amino Acid Motifs; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D015684:Gene Products, pol / Q000235:genetics*; D006513:Hepatitis B e Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D009154:Mutation
chemical_list: D000998:Antiviral Agents; D015684:Gene Products, pol; D006513:Hepatitis B e Antigens; C066027:P protein, Hepatitis B virus; D019259:Lamivudine