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Virological and biochemical relapse according to YMDD motif mutant type during long-term lamivudine monotherapy.
- Source :
-
Journal of medical virology [J Med Virol] 2003 Dec; Vol. 71 (4), pp. 504-10. - Publication Year :
- 2003
-
Abstract
- Whether the type of lamivudine-resistant virus in hepatitis B virus (HBV) influences the clinical outcome, it is not completely understood. We evaluated the serial changes in YMDD motif mutant in 60 Japanese genotype C-HBV patients who received long-term lamivudine monotherapy. YIDD or YVDD alone tended to stop shifting to the mixed type (YVDD and YIDD) within 12 months after the detection of mutant virus. Hence, the characteristics, virological relapse (DNA breakthrough) and biochemical relapse (breakthrough hepatitis) of 49 patients, who could be classified into three types (continuous YVDD, continuous YIDD, and the mixed type), were investigated. YVDD and YIDD type tended to have the opposite background with regard to age, histology, and viral load. The mixed and YIDD types tended to have similar backgrounds, except for viral load. In the mixed type, both the HBeAg-positive rate and viral load as risk factors for emergence of the mutant tended to be high. Mutant virus, DNA breakthrough and breakthrough hepatitis emerged significantly earlier in the mixed type than the two other types. The incidence of severe breakthrough hepatitis accompanied by icteric flare-up tended to be higher in the mixed type than the other types. Our results suggest that the YMDD motif mutant type might emerge from different backgrounds and modulate the virological and biochemical relapse after the emergence. Large-scale studies of each mutant type should be conducted in the future to confirm these findings.<br /> (Copyright 2003 Wiley-Liss, Inc.)
- Subjects :
- Adult
Aged
Amino Acid Motifs
Amino Acid Sequence
Antiviral Agents administration & dosage
Female
Gene Products, pol chemistry
Gene Products, pol genetics
Genes, Viral
Genotype
Hepatitis B virus enzymology
Hepatitis B virus isolation & purification
Hepatitis B, Chronic metabolism
Humans
Lamivudine administration & dosage
Male
Middle Aged
Mutation
Recurrence
Time Factors
Antiviral Agents therapeutic use
Hepatitis B virus drug effects
Hepatitis B virus genetics
Hepatitis B, Chronic drug therapy
Hepatitis B, Chronic virology
Lamivudine therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 0146-6615
- Volume :
- 71
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical virology
- Publication Type :
- Academic Journal
- Accession number :
- 14556262
- Full Text :
- https://doi.org/10.1002/jmv.10519