title: Quantification of lamivudine-resistant hepatitis B virus mutants by type-specific TaqMan minor groove binder probe assay in patients with chronic hepatitis B.
abstract: BACKGROUND
  Lamivudine (LAM)-resistant hepatitis B virus (HBV) with mutations in the polymerase region frequently appears after long-term use of LAM. Several methods allowing detection of mutant strains (YIDD, YVDD) have been reported, but they have no quantitative characteristics. In this study, we explored a unique approach for quantification of each mutant strain.
  
  
  METHODS
  A method for detection and quantification of wild and mutant strains was developed using realtime polymerase chain reaction and type-specific minor groove binder (MGB) probes, and tested in patients with chronic hepatitis B before and after additive treatment with adefovir dipivoxil (ADV).
  
  
  RESULTS
  A good correlation was confirmed in HBV DNA quantity obtained between the YMDD-specific MBG probe assay and Amplicor HBV Monitor assay results (P < 0.001), linear between 3 and 9 log copies/mL serum. Of 109 samples from patients with chronic hepatitis B tested by both these assays and conventional direct sequencing, 90 (88.2%) showed identical results. The assays successfully detected and quantified a single type of mutant in three of four patients with additive ADV treatment, and also two coexisting mutant types (YIDD and YVDD) in the remaining patient.
  
  
  CONCLUSIONS
  Our specific and sensitive method for detection and quantification of HBV DNA with the wild-type YMDD motif and its two mutant forms (YIDD and YVDD) appears to be clinically useful, especially in patients with multiple mutant HBV infections.
authors.affiliation: Department of Health Sciences, Hokkaido University School of Medicine, North-12 West-5, Sapporo, Japan. shiyoshi@med.hokudai.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yoshida
authors.forename: Shuhei
authors.initials: S
authors.lastname: Hige
authors.forename: Miyuki
authors.initials: M
authors.lastname: Yoshida
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamashita
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Fujisawa
authors.forename: Kaori
authors.initials: K
authors.lastname: Sato
authors.forename: Tadashiro
authors.initials: T
authors.lastname: Kitamura
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Makoto
authors.initials: M
authors.lastname: Chuma
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Chiba
mesh_terms: D001483:Base Sequence; D015342:DNA Probes / Q000032:analysis* / Q000235:genetics; D024882:Drug Resistance, Viral / Q000235:genetics*; D006515:Hepatitis B virus / Q000187:drug effects* / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use; D009154:Mutation / Q000235:genetics*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019914:Taq Polymerase / Q000378:metabolism*
chemical_list: D015342:DNA Probes; D019259:Lamivudine; D019914:Taq Polymerase