Brief Article
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World J Gastroenterol. Dec 7, 2011; 17(45): 4987-4992
Published online Dec 7, 2011. doi: 10.3748/wjg.v17.i45.4987
Lamivudine resistance mutations in patients infected with hepatitis B virus genotype D
Orhan Yıldız, Bilgehan Aygen, Nese Demirtürk, Tuna Demirdal, Dilara Inan, Taner Yıldırmak, Arzu Kantürk, Ediz Tütüncü, Hepatitis B Study Group
Orhan Yıldız, Bilgehan Aygen, Department of Infectious Diseases and Clinical Microbiology, Medical School of Erciyes University, 38039 Kayseri, Turkey
Nese Demirtürk, Tuna Demirdal, Department of Infectious Diseases and Clinical Microbiology, Medical School of Kocatepe University, 03030 Afyon, Turkey
Dilara Inan, Department of Infectious Diseases and Clinical Microbiology, Medical School of Akdeniz University, 07058 Antalya, Turkey
Taner Yıldırmak, Arzu Kantürk, Okmeydani Training and Research Hospital of the Ministry of Health, 34384 Istanbul, Turkey
Ediz Tütüncü, SB Diskapi Yildirim Beyazit Training and Research Hospital of the Ministry of Health, 06110 Ankara, Turkey
Hepatitis B Study Group, Sıla Akhan, Celal Ayaz, Mustafa Çelen, Nurcan Baykam, Kenan Hızel, Uner Kayabas, O Faruk Kokoglu, Hasan Ucmak, Sukran Kose, Resit Mıstık, Oral Oncul, Nese Saltoglu, Lutfu Savas, Yusuf Onlen, Necla Tulek
Author contributions: Yıldız O and Aygen B designed the study, directed its implementation, supervised all the field activities, contributed to the analysis and interpretation of the data, and to the redaction of the manuscript; Demirtürk N, Demirdal T, Inan D, Yıldırmak T, Kantürk A and Tütüncü E contributed to the analysis and interpretation of the data; all authors read and approved the final manuscript.
Correspondence to: Orhan Yıldız, MD, Associate Professor, Erciyes Universitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları Kliniği, 38039 Kayseri, Turkey. oyildiz@erciyes.edu.tr
Telephone: +90-352-4374937 Fax: +90-352-4374948
Received: April 6, 2011
Revised: July 4, 2011
Accepted: July 11, 2011
Published online: December 7, 2011
Abstract

AIM: To determine the distribution of viral genotypes for primary or acquired lamivudine resistance.

METHODS: A total of 283 patients with chronic hepatitis B virus (HBV) infection (245 patients with chronic hepatitis B and 38 inactive hepatitis B surface antigen carriers) were included in the study. The HBV genotype was determined by using quantitative real-time polymerase chain reaction and sequence analysis, and tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations were determined using the reverse transcriptase hybridization method.

RESULTS: Lamivudine resistance was determined in a total of 25 (10.7%) chronic hepatitis B patients. Eight subjects (4%) had primary resistance to lamivudine, and 17 (53.1%) had secondary resistance to lamivudine. Genotype D, which was isolated from 267 of the patients with chronic HBV infection, was the dominant genotype in Turkey.

CONCLUSION: Identification of YMDD motif mutations should have a positive impact on the selection of proper antiviral medication for patients, even for those who are nucleoside naïve.

Keywords: Hepatitis B virus; Genotype; Resistance; Lamivudine; Tyrosine-methionine-aspartate-aspartate mutation