Thai Journal of Gastroenterology

Article :
Changes of DNA Sequence in Polymerase Gene after Adefovir Treatment for Lamivudine Failure in Chronic Hepatitis B

Author :
Monthira Maneerattanaporn, M.D.
Duanjit Kanit-thanon, M.D., Ph.D.
Suthipol Udompunthurak
Taweesak Tanwandee, M.D.*

Abstract :

Background: Adefovir dipivoxil (ADV) is a new nucleotide analogue against HBV with low inci-
dence of resistance mutation in naive chronic hepatitis B (CHB) and has no cross resistance to lamivudine resistance mutation.

Objectives: To characterize genotypic mutation of HBV polymerase gene after 1 year of ADV treatment in lamivudine failure CHB and to correlate polymerase mutation with response to ADV treatment.

Methods: The serum HBV DNA was quantified by a real time PCR at entry of study, 3 month and 12
month after initiation of adefovir dipivoxil.  Then DNA sequencing was performed to demonstrate mutation.

Results: The DNA sequencing confirmed YMDD mutation at entry.  HBV DNA viral load level was
dramatically reduced winhin the first 3 and at 12 month in almost of the patients.  There were only 2 of 32 patients who initially decreased of HBV DNA viral load at 3 month but then gradually rising at the end of study.

Conclusion: Adefovir is effective in recurrent chronic hepatitis B patients with YMDD mutation. Most
of the patient treated with lamivudine showed viral recurrent. (31 of 32 patients, 96.87%)  However, only one
patient showed a rebound of HBV DNA after 12 months of treatment by ADV.

[Thai J Gastroenterol 2006; 7(3): 137-142]

Keyword :
adefovir, lamivudine, chronic hepatitis B, DNA sequence

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