YMDD mutations in patients with chronic hepatitis B untreated with antiviral medicines

February 16, 2005

YMDD mutations in patients with chronic hepatitis B untreated with antiviral

medicines.

World J Gastroenterol 2005 February;11(6):867-870

Huang ZM, Huang QW, Qin YQ, He YZ, Qin HJ, Zhou YN, Xu X, Huang MJ.

Department of Infectious Diseases, The Affiliated Hospital of YouJiang

Medical College for Nationalities, Baise 533000, Guangxi Zhuang Autonomous

Region, China. zhongminhuang@...

AIM: To polymerase P region (YMDD) mutations of hepatitis B virus gene (HBV

DNA) in patients with chronic hepatitis B (CHB) untreated with antiviral

medicines and to explore its correlation with pre-c-zone mutations, HBV

genotypes and HBV DNA level, and to observe its curative effect. METHODS: A

total of 104 cases (38 cases in group of familial aggregation and 66 cases

in group of non-familial aggregation) were randomly chosen from 226 patients

with CHB who did not receive the treatment of lamivudine (LAM) and any other

antivirus drugs within the last one year. Their serum YMDD mutations were

detected by microcosmic nucleic acid and cross-nucleic acid quantitative

determination, HBV genotypes by PCR-microcosmic nucleic acid cross-ELISA,

HBV DNA quantitative determination and fluorescence ration PCR analysis,

hepatitis B virus markers (HBVM) by ELISA. LAM was taken by 10 patients with

YMDD mutations and its curative effect was observed. RESULTS: Twenty-eight

cases (26.9%) had YMDD mutations, of them 11 cases (28.9%) were in familial

aggregation group (38 cases) and 17 cases (25.8%) in non-familial

aggregation group (66 cases) with no significant difference between the two

groups. Twenty-seven point one percent (16/59) cases were positive for HBeAg

YMDD mutations, and 26.7% (12/45) cases were negative for HBeAg and positive

for anti-HBe. There was also no significant difference between the two

groups. Different YMDD incidence rate existed in different HBV genotypes.

HBV DNA level did not have a positive correlation with the incidence of YMDD

mutations. LAM was effective for all patients with mutations. CONCLUSION:

Wild mutant strains in HBV and their incidence rate have no significant

difference between familial aggregation and non-familial aggregation. It may

have no significant relationship between YMDD mutations and pre-c-zone

mutations. HBV DNA level may not have a positive correlation with YMDD

mutations. LAM is clinically effective for CHB patients with YMDD mutations.

February 16, 2005