Management of chronic hepatitis B infection: Current treatment guidelines, challenges, and new developments

Table 6 Antiviral resistance patterns and rescue therapy

Resistance	Mutation patterns	Treatment adaptation
LAM	M204V/I + L180M M204I M204V + L180M + V173L M204I + L180I Q215S + M204I/V + M204V I169T + V173L + L180M + M204V A181T T184S + M204I/V + L180M M204S + L180M	Switch to TDF or Switch to ETV + ADV combination therapy or Add ADV if TDF or ETV unavailable
ADV	A181V/T N236T A181V/T + N236T	Switch to TDF and add ETV
ADV + LAM	A181V/T + N236T L80V/I	Switch to TDF and add ETV
TBV	M204I/V ± L180M L80I/V ± L180M A181T/V	Switch to or add TDF
ETV	L180M + M204V/I ± I169T ± M250V L180M + M204V/I ± T184G ± S202I/G	Switch to or add TDF
TDF	No known mutations	N/A

Common mutation patterns, and rescue therapies suggested by the American Association for the Society of Liver Disease, Asian Pacific Association for the Study of Liver; European Association for the Study of Liver and National Institute for Health and Care Excellence. LAM: Lamivudine; ETV: Entecavir; ADV: Adefovir; TBV: Telbivudine; TDF: Tenofovir disoproxil fumarate.