title: Analysis of reverse transcriptase gene mutations in the hepatitis B virus at a university hospital in Korea.
abstract: BACKGROUND
  Most mutations in the reverse transcriptase (RT) gene of the hepatitis B virus (HBV) are related to resistance to antiviral agents. Cross-sectional studies on the mutations of this gene are rare. Thus, we analyzed the mutation patterns of RT genes and their biochemical parameters.
  
  
  METHODS
  From 2009 to 2012, 301 blood specimens from patients with chronic hepatitis B at Daegu Catholic University Medical Center were retrospectively analyzed for the RT gene sequence of HBV, ALT, hepatitis B e antigen (HBeAg), and HBV DNA. The mutation patterns of the RT gene were compared with the biochemical parameters.
  
  
  RESULTS
  Of the 301 patients, 100 (33.2%) had no RT gene mutations. The remaining showed the following mutation patterns: rtM204I/V (50.2%), rtL180M (39.2%), and rtA181T/V (19.6%). Combined mutations were found in 146 cases (48.5%). Of these, the combination of amino acid changes at rt180+rt204 (49.3%) was most frequently detected, followed by rt181+rt236 (11.0%) and rt173+rt180+rt204 (9.6%). In the mutated group, HBV DNA and HBeAg positive rates were significantly higher (P<0.05 for both). Phenotypic analysis showed that lamivudine resistance was most frequently detected (34.6%), followed by adefovir resistance (15.6%). Multidrug resistance was detected in 48 cases (15.9%). The adefovir-resistant group had a higher proportion of cases with HBV loads greater than 2,000 IU/mL.
  
  
  CONCLUSIONS
  We found correlations between the mutation status of the RT domain and biochemical parameters such as HBV DNA and HBeAg positive rate. The presence of RT gene mutations could therefore be utilized to predict clinical status.
authors.affiliation: Department of Laboratory Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea.
authors.forename: A-Jin
authors.initials: AJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea.
authors.forename: Chang Hyeong
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Laboratory Medicine, College of Medicine, Catholic University of Daegu, Daegu, Korea.
authors.forename: Chang-Ho
authors.initials: CH
authors.lastname: Jeon
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004279:DNA, Viral / Q000032:analysis; D024921:Drug Resistance, Multiple, Viral; D024882:Drug Resistance, Viral; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000201:enzymology* / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000188:drug therapy; D006785:Hospitals, University; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D009154:Mutation; D063065:Organophosphonates / Q000627:therapeutic use; D010641:Phenotype; D012194:RNA-Directed DNA Polymerase / Q000235:genetics*; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D012194:RNA-Directed DNA Polymerase; D000225:Adenine
keywords: Alanine aminotransferase; Hepatitis B e antigen; Hepatitis B virus; Mutation; Reverse transcriptase