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Lamivudine resistance in immunocompetent chronic hepatitis B. Incidence and patterns
P Honkoop1, H G Niesters, R A de Man
1Department of Internal Medicine II, Erasmus University Hospital Rotterdam, The Netherlands.
Background:
Lamivudine is a non-toxic, potent inhibitor of hepatitis B virus replication. Recently, hepatitis B virus resistance to lamivudine has been described in patients using immunosuppressive drugs after liver transplantation.
Methods:
From our cohort of 81 consecutive patients treated with lamivudine, we selected all immunocompetent patients who received lamivudine monotherapy for a period over 26 weeks (n=14).
Results:
Lamivudine resistance with the characteristic mutation in the YMDD motif was observed in four patients (actuarial cumulative incidence: 39%). Two patterns of viral resistance were observed: incomplete response (n=2) and viral breakthrough (n=2).
Conclusions:
The observed high frequency of lamivudine resistance may have implications for the concept of long-term virus-suppressive therapy of chronic hepatitis B by lamivudine monotherapy.