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Received: 2005-06-14

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Journal of Zhejiang University SCIENCE B 2005 Vol.6 No.12 P.1182~1187

10.1631/jzus.2005.B1182


Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy


Author(s):  LIU Ke-zhou, HOU Wei, ZUMBIKA Edward, NI Qin

Affiliation(s):  Institute of Infectious Diseases, First Affiliated Hospital, School of Medcine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   liukezhou@zju.edu.cn

Key Words:  Chronic hepatitis B (CHB), Tyrosine-methionine-aspartate-aspartate (YMDD) mutation, Lamivudine


LIU Ke-zhou, HOU Wei, ZUMBIKA Edward, NI Qin. Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy[J]. Journal of Zhejiang University Science B, 2005, 6(8): 1182~1187.

@article{title="Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy",
author="LIU Ke-zhou, HOU Wei, ZUMBIKA Edward, NI Qin",
journal="Journal of Zhejiang University Science B",
volume="6",
number="12",
pages="1182~1187",
year="2005",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.2005.B1182"
}

%0 Journal Article
%T Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy
%A LIU Ke-zhou
%A HOU Wei
%A ZUMBIKA Edward
%A NI Qin
%J Journal of Zhejiang University SCIENCE B
%V 6
%N 12
%P 1182~1187
%@ 1673-1581
%D 2005
%I Zhejiang University Press & Springer

TY - JOUR
T1 - Clinical features of chronic hepatitis B patients with YMDD mutation after lamivudine therapy
A1 - LIU Ke-zhou
A1 - HOU Wei
A1 - ZUMBIKA Edward
A1 - NI Qin
J0 - Journal of Zhejiang University Science B
VL - 6
IS - 12
SP - 1182
EP - 1187
%@ 1673-1581
Y1 - 2005
PB - Zhejiang University Press & Springer
ER -


Abstract: 
Objective: To study the clinical features of chronic hepatitis B (CHB) patients with tyrosine-methionine-aspartate-aspartate (YMDD) mutation after lamivudine therapy. Methods: This investigation was a retrospective study of 63 CHB patients with YMDD mutation during lamivudine therapy. Clinical data, including period and types of YMDD mutation; hepatitis B virus (HBV) DNA levels and alanine aminotransferase (ALT) levels before and after YMDD mutation were measured. YMDD mutation in the HBV DNA polymerase gene was determined using polymerase chain reaction (PCR) and direct sequencing. HBV DNA quantification was determined using real-time PCR. Relevant serum markers of HBV were measured. The follow-up period was 12 months after YMDD mutation. Results: YMDD mutation occurred 7~44 months (median, 21.5 months) after the start of lamivudine therapy. The majority of the cases (42/63, 66.6%) had YMDD mutants detected between 12 and 24 months. Four types of YMDD mutation were observed in this study, rtL180M/M204V mutation was the predominant type (26/63, 41.3%). A proportion of patients (16/63, 25.4%; 12/63, 19.1%) had higher HBV DNA levels and ALT levels (after mutation vs before mutation), respectively. Conclusion: The majority of patients with YMDD mutants had similar or lower HBV DNA levels and ALT levels compared with baseline values. This subset of patients might have benefited from the continued lamivudine therapy. The patients with increased ALT and HBV DNA levels (breakthrough hepatitis) should benefit from the addition of a newer nucleotide analogue (e.g. adefovir).

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