Prevalence and clinical characterization of patients with acute hepatitis B induced by lamivudine-resistant strains

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http://www3.interscience.wiley.com/journal/123240797/abstract

Journal of Gastroenterology and Hepatology

Early View (Articles online in advance of print)

Published Online: 13 Jan 2010

Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and Journal of

Gastroenterology and Hepatology Foundation

HEPATOLOGY

Prevalence and clinical characterization of patients with acute hepatitis B

induced by lamivudine-resistant strains

Kazuhiko Hayashi,* Yoshiaki Katano,* Masatoshi Ishigami,* Akihiro Itoh,* Yoshiki

Hirooka,* Isao Nakano,* Kentaro Yoshioka, † Motoyoshi Yano, ‡ Hidenori Toyoda, §

Takashi Kumada § and Hidemi Goto*

*Department of Gastroenterology, Nagoya University Graduate School of Medicine,

Nagoya, Japan, † Division of Liver and Biliary Diseases, Department of

Internal Medicine, Fujita Health University, Toyoake, Japan, ‡ Department of

Gastroenterology, Yokkaichi Municipal Hospital, Yokkaichi, Japan and §

Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan

Correspondence to Yoshiaki Katano, Department of Gastroenterology, Nagoya

University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya

466-8550, Japan. Email: ykatano@...

Copyright Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Background and Aims: 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.

Conclusion: 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.

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Accepted for publication 26 August 2009.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2009.06118