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Quasispecies and pre-existing drug-resistant mutations of hepatitis B virus in patients with chronic hepatitis B.

ABSTRACT: To investigate pre-existing hepatitis B virus (HBV) quasispecies and the genotypic evolution of several variants.From six patients with lamivudine (LAM) failure, serum samples at pretreatment, 6 months of LAM therapy, and virologic breakthrough were obtained. One hundred clones with HBV inserts in each patient were sequenced at each time point. Pretreatment serum samples were also analyzed from six patients who achieved good responses to LAM therapy.Among the six patients with LAM failure, the analysis of 100 clones from patient 1 revealed the substitutions L180M in 1% of clones and V173L in 2% of clones. Patient 2 had substitutions of L80V, W153Q, and L180M. In patient 3, mutations conferring resistance to adefovir at V84I (5%), I169L (1%), and N236H (7%) and entecavir at S202G (2%) were detected. Patient 4 had mutations at T128N (1%), I169L (1%), V173L (2%), A181V (1%), and Q215H (1%). In patient 5, M204V/I was detected in 1% and 2% of clones, respectively. L80I and V173L were also identified in patient 6. In the six patients who responded to LAM, the degree of overall quasispecies was less than those with LAM failure.Various HBV quasispecies associated with drug resistance existed before treatment, and the quasispecies dynamically changed through LAM therapy.

SUBMITTER: Kim DY

PROVIDER: S-EPMC3661966 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Quasispecies and pre-existing drug-resistant mutations of hepatitis B virus in patients with chronic hepatitis B.

Kim Do Young DY Chang Hye Young HY Lim Sun Min SM Kim Seung Up SU Park Jun Yong JY Kim Ja Kyung JK Lee Kwan Sik KS Han Kwang-Hyub KH Chon Chae Yoon CY Ahn Sang Hoon SH

Gut and liver 20130409 3

<h4>Background/aims</h4>To investigate pre-existing hepatitis B virus (HBV) quasispecies and the genotypic evolution of several variants.<h4>Methods</h4>From six patients with lamivudine (LAM) failure, serum samples at pretreatment, 6 months of LAM therapy, and virologic breakthrough were obtained. One hundred clones with HBV inserts in each patient were sequenced at each time point. Pretreatment serum samples were also analyzed from six patients who achieved good responses to LAM therapy.<h4>Re ...[more]

PMID: 23710315

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Project description:BACKGROUND:It is unclear whether immune escape-associated mutations in the major hydrophilic region of hepatitis B virus surface antigen (HBsAg) are associated with nucleoside/nucleotide analog resistance. AIM:To evaluate the association between immune escape-associated mutations and nucleoside/nucleotide analog resistance mutations. METHODS:In total, 19440 patients with chronic hepatitis B virus infection, who underwent resistance testing at the Fifth Medical Center of Chinese PLA General Hospital between July 2007 and December 2017, were enrolled. As determined by sequence analysis, 6982 patients harbored a virus with resistance mutations and 12458 harbored a virus lacking resistance mutations. Phenotypic analyses were performed to evaluate HBsAg production, replication capacity, and drug-induced viral inhibition of patient-derived drug-resistant mutants with or without the coexistence of sA159V. RESULTS:The rate of immune escape-associated mutation was significantly higher in 9 of the 39 analyzed mutation sites in patients with resistance mutations than in patients without resistance mutations. In particular, these mutations were sQ101H/K/R, sS114A/L/T, sT118A/K/M/R/S/V, sP120A/L/Q/S/T, sT/I126A/N/P/S, sM133I/L/T, sC137W/Y, sG145A/R, and sA159G/V. Among these, sA159V was detected in 1.95% (136/6982) of patients with resistance mutations and 1.08% (134/12,458) of patients lacking resistance mutations (P < 0.05). The coexistence of sA159V with lamivudine (LAM) and entecavir (ETV)-resistance mutations in the same viral genome was identified during follow-up in some patients with drug resistance. HBsAg production was significantly lower and the replication capacity was significantly higher, without a significant difference in LAM/ETV susceptibility, in sA159V-containing LAM/ETV-resistant mutants than in their sA159V-lacking counterparts. CONCLUSION:In summary, we observed a close link between the increase in certain immune escape-associated mutations and the development of resistance mutations. sA159V might increase the fitness of LAM/ETV-resistant mutants under environmental pressure in some cases.

Dataset Information

Quasispecies and pre-existing drug-resistant mutations of hepatitis B virus in patients with chronic hepatitis B.

Publications

Quasispecies and pre-existing drug-resistant mutations of hepatitis B virus in patients with chronic hepatitis B.

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