title: Prevalence and clinical characterization of patients with acute hepatitis B induced by lamivudine-resistant strains.
abstract: OBJECTIVE
  Acute hepatitis caused by lamivudine (LMV)-resistant strains has not been reported, and the clinical impact of LMV-resistant strains on acute hepatitis is not known. The aim of this study was to investigate the molecular and clinical characteristics of patients with acute hepatitis B caused by LMV-resistant strains.
  
  
  METHODS
  Forty-five patients with acute hepatitis B were studied. Hepatitis B virus (HBV) subgenotypes and LMV-resistance mutations were determined by direct sequencing of the preS and polymerase regions, respectively.
  
  
  RESULTS
  HBV subgenotypes A2 (n = 18), B1 (n = 1), B2 (n = 3), B3 (n = 2), C1 (n = 1), C2 (n = 19) and C6 (n = 1) were detected in patients with acute hepatitis. LMV-resistance mutations were detected in two patients. LMV-resistance mutations (L180M, M204I) were detected in a patient with subgenotype C2 who had acute self-limited hepatitis. The other patient with LMV-resistance mutations (L180M, M204V) was infected with subgenotype A2 and had severe hepatitis.
  
  
  CONCLUSIONS
  LMV-resistant strains are rare, but they are starting to be found in patients with acute hepatitis B. Surveillance for detecting drug-resistant HBV strains would be important for clinical practice.
authors.affiliation: Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hayashi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Katano
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Ishigami
authors.forename: Akihiro
authors.initials: A
authors.lastname: Itoh
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Hirooka
authors.forename: Isao
authors.initials: I
authors.lastname: Nakano
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Yano
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.forename: Hidemi
authors.initials: H
authors.lastname: Goto
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D004252:DNA Mutational Analysis; D004259:DNA-Directed DNA Polymerase / Q000235:genetics*; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D015995:Prevalence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; D004259:DNA-Directed DNA Polymerase