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Variant of Hepatitis B Virus with Primary Resistance to Adefovir

2006; Massachusetts Medical Society; Volume: 354; Issue: 17 Linguagem: Inglês

10.1056/nejmoa051214

1533-4406

Oliver Schildgen, Hueseyin Sirma, Anneke Funk, Cynthia Olotu, Ulrike C. Wend, Heinz Hartmann, Martin Helm, Jürgen K. Rockstroh, Wulf R. Willems, Hans Will, Wolfram H. Gerlich,

Liver Disease Diagnosis and Treatment

The reverse-transcriptase inhibitor lamivudine (Zeffix, GlaxoSmithKline) is often used to treat chronic infection with hepatitis B virus (HBV) until resistance develops. Treatment may then be switched to the reverse-transcriptase inhibitor adefovir (Hepsera, Gilead), which has a lower frequency of resistance. Here, we describe three cases of primary adefovir resistance that were sensitive to tenofovir (Viread, Gilead). All three cases involved a rare HBV variant with a valine at position 233 of the reverse-transcriptase domain instead of isoleucine (rtI233V), as in the wild-type virus. This HBV variant also displayed resistance to adefovir and sensitivity to tenofovir in vitro.