Prevalence and clinical characterization of patients with acute hepatitis B induced by lamivudine-resistant strains.
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.
Hayashi
Kazuhiko
K
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Katano
Yoshiaki
Y
Ishigami
Masatoshi
M
Itoh
Akihiro
A
Hirooka
Yoshiki
Y
Nakano
Isao
I
Yoshioka
Kentaro
K
Yano
Motoyoshi
M
Toyoda
Hidenori
H
Kumada
Takashi
T
Goto
Hidemi
H
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
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine; D004259:DNA-Directed DNA Polymerase