[Occurrence and predictive factors of hepatitis B virus polymerase YMDD variation among patients with chronic hepatitis B and liver cirrhosis during lamivudine therapy].
OBJECTIVE
To study the incidence and the predictive factors of HBV polymerase YMDD variation among patients with chronic hepatitis B and liver cirrhosis during lamivudine therapy.


METHODS
The clinical data and serial sera of 313 chronic HBV infected patients (249 chronic hepatitis B and 64 liver cirrhosis) treated with lamivudine were collected. YMDD variations were determined by mispairing PCR-RFLP assay. The data were analyzed using SPSS software.


RESULTS
The cumulative rates of variation among patients with chronic hepatitis B and liver cirrhosis were 8.84% and 17.19%, 20.91% and 32.40%, 26.92% and 39.56%, 26.92% and 58.79% after 12, 24, 36 and 48 months of lamivudine treatment, respectively. The results of log-rank test and Cox's proportional hazard model analysis indicated that lamivudine monotherapy, low ALT level, high HBV DNA level, and the patients with liver cirrhosis at baseline were significantly related to an occurrence of YMDD variation.


CONCLUSIONS
This study suggests that lower ALT and higher HBV DNA levels at baseline before lamivudine treatment, lamivudine monotherapy without combining alpha-interferon, and the patients with liver cirrhosis seem to be statistically significant for predicting the occurrence of YMDD variation.
Wang
Lei
L
Department of Infectious Diseases, Medical College, Shandong University, Ji'nan 250021, China.
Yan
Jie
J
Zhang
Zhao-hua
ZH
Wang
Jing-bo
JB
Du
Yi-zhen
YZ
Li
Xiao-ying
XY
Wang
Yao-zong
YZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D020816:Amino Acid Motifs / Q000235:genetics; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D004259:DNA-Directed DNA Polymerase / Q000235:genetics; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009154:Mutation
D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine; D004259:DNA-Directed DNA Polymerase