title: YMDD mutations in patients with chronic hepatitis B untreated with antiviral medicines.
abstract: OBJECTIVE
  To polymerase P region (YMDD) mutations of hepatitis B virus gene (HBV DNA) in patients with chronic hepatitis B (CHB) untreated with antiviral medicines and to explore its correlation with pre-c-zone mutations, HBV genotypes and HBV DNA level, and to observe its curative effect.
  
  
  METHODS
  A total of 104 cases (38 cases in group of familial aggregation and 66 cases in group of non-familial aggregation) were randomly chosen from 226 patients with CHB who did not receive the treatment of lamivudine (LAM) and any other antivirus drugs within the last one year. Their serum YMDD mutations were detected by microcosmic nucleic acid and cross-nucleic acid quantitative determination, HBV genotypes by PCR-microcosmic nucleic acid cross-ELISA, HBV DNA quantitative determination and fluorescence ration PCR analysis, hepatitis B virus markers (HBVM) by ELISA. LAM was taken by 10 patients with YMDD mutations and its curative effect was observed.
  
  
  RESULTS
  Twenty-eight cases (26.9%) had YMDD mutations, of them 11 cases (28.9%) were in familial aggregation group (38 cases) and 17 cases (25.8%) in non-familial aggregation group (66 cases) with no significant difference between the two groups. Twenty-seven point one percent (16/59) cases were positive for HBeAg YMDD mutations, and 26.7% (12/45) cases were negative for HBeAg and positive for anti-HBe. There was also no significant difference between the two groups. Different YMDD incidence rate existed in different HBV genotypes. HBV DNA level did not have a positive correlation with the incidence of YMDD mutations. LAM was effective for all patients with mutations.
  
  
  CONCLUSIONS
  Wild mutant strains in HBV and their incidence rate have no significant difference between familial aggregation and non-familial aggregation. It may have no significant relationship between YMDD mutations and pre-c-zone mutations. HBV DNA level may not have a positive correlation with YMDD mutations. LAM is clinically effective for CHB patients with YMDD mutations.
authors.affiliation: Department of Infectious Diseases, The Affiliated Hospital of YouJiang Medical College for Nationalities, Baise 533000, Guangxi Zhuang Autonomous Region, China. zhongminhuang@msn.com
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Huang
authors.forename: Qi-Wen
authors.initials: QW
authors.lastname: Huang
authors.forename: Ya-Qin
authors.initials: YQ
authors.lastname: Qin
authors.forename: Yan-Zhuan
authors.initials: YZ
authors.lastname: He
authors.forename: Hou-Ji
authors.initials: HJ
authors.lastname: Qin
authors.forename: Yiao-Nan
authors.initials: YN
authors.lastname: Zhou
authors.forename: Xiang
authors.initials: X
authors.lastname: Xu
authors.forename: Mei-Jin
authors.initials: MJ
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000235:genetics; D006515:Hepatitis B virus / Q000187:drug effects / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D006513:Hepatitis B e Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine