title: Rethinking therapeutic decisions for hepatitis B infection in Syria: insights into molecular monitoring.
abstract: BACKGROUND
  Hepatitis B virus patients are usually treated in Syria with alpha interferon and nucleos(t)ide analogues. Genotypic viral factors causing inadequate response or relapse following initial response are not routinely investigated. This study aimed to explore and discuss local therapeutic decisions from a molecular perspective.
  
  
  METHODS
  Fifty patients with hepatitis B from Syria were tested for HBV genotyping and drug-resistance mutations by DNA sequencing.
  
  
  RESULTS
  All patients had genotype D, which is characterized by relatively low response to interferon-based therapy. Drug-resistant viral mutant variants were detected in one fifth of the enrolled patients, and distributed similarly in both nucleos(t)ide analogues-naïve and -treated patients. However, nucleos(t)ide analogues-based therapy was associated with the existence of more mutations and hence increased resistance.
  
  
  CONCLUSIONS
  Investigating HBV genotypes and drug-resistance mutations to support treatment decisions is critically needed for efficient therapy and patients' survival.
authors.affiliation: Clinical Laboratories Department, Al-Assad Hospital, Damascus University, Damascus, Syria. wafahabbal@hotmail.com
authors.forename: Wafa
authors.initials: W
authors.lastname: Habbal
authors.forename: Fawza
authors.initials: F
authors.lastname: Monem
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D024882:Drug Resistance, Viral; D005838:Genotype; D006509:Hepatitis B / Q000188:drug therapy* / Q000821:virology*; D006515:Hepatitis B virus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D009705:Nucleosides / Q000008:administration & dosage; D017422:Sequence Analysis, DNA; D013593:Syria; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D016898:Interferon-alpha; D009705:Nucleosides