Paper Information

Journal:   GOVARESH JOURNAL   FALL 2015 , Volume 20 , Number SUPPLEMENT; Page(s) 14 To 14.
 
Paper: 

FREQUENCY OF YMMD MUTATION DUE TO LAMIVUDINE IN HBV PATIENTS

 
 
Author(s):  ABDOLLAHIAN MAJID*, SABERI FIRUZI MEHDI, KAVIANI MOJGAN, TAGHAVI SEYED ALIREZA, MEHRABANI DAVOOD
 
* LORESTAN UNIVERCITY OF MEDICAL SCIENCE
 
Abstract: 

Introduction: Emergence of YMDD mutation may occure duo to long Term Treatment of chronic HBV and post transplant and HBV cirrhosis with lamivudine that Lamivudine resistant mutants frequently develop. The aim of this study was evaluation of YMDD mutation due to long term treatment with lamivudine and its association with duration of treatment and HBV genotype in Iranian patients between 2005 and 2006 in Shiraz.
Methods: This study was performed on 89 patients, 72 (males) and 17 (females) with background disease of chronic HBV (40 pts), HBV induced liver cirrhosis (40 pts), post orthotopic liver transplantation (9 pts) that were on constant lamivudine treatment for more than one year. ACRS- PCR Method for detection of YMDD mutation and Gap-CR method for HBV genotype were used and serologic and biochemical study for detection of HbeAg and HbeAb and ALT were done.
Results: 43 out of 89 patients (48.3%) had mutation of rtM204 I/V and 46 pts (51.7%) had no mutations.
Frequency of mutations with use of more than 1 year of lamivudine were 50% and in patients with use of lamivudine more than 2 and 3 and 4 years were 45.4%, 56.2% and 42.1% respectively.17 patients (39.5%) had YVDD and 18 pts (41.9%) had YIDD and 8 (18.6%) had combination of YVDD+YIDD.
All patients had genotype D. In 43 patients with rtM204 I/V mutations in the course of treatment 18pts (14.9%) had HbeAg+, 25pts (58.1%) HbeAg- and 21pts (48.8%) were HbeAg-, HbeAg+. Mean serum ALT in the course of treatment in patients with YMDD mutation was 46.7 ±25.7 and in patients without mutations was 44.5± 25.68.
Conclusion: YMDD mutations were common in our patients. In comparison with other studies frequency of mutations were higher with shorter treatment and after relative increase with moderate duration use of lamivudine the frequency of mutations were lower than other studies and there was’nt linear increase of mutations with duration of treatment. In spite of the fact that 100% of our patients were genotype D there were no any relation between other genotypes and YMDD mutations.

 
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