Journal Article

Prevalence and Clinical Correlates of YMDD Variants during Lamivudine Therapy for Patients with Chronic Hepatitis B

Ching-Lung Lai, Jules Dienstag, Eugene Schiff, Nancy W. Y. Leung, Mark Atkins, Christine Hunt, Nathaniel Brown, Mary Woessner, Richard Boehme and Lynn Condreay

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 36, issue 6, pages 687-696
Published in print March 2003 | ISSN: 1058-4838
Published online March 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/368083
Prevalence and Clinical Correlates of YMDD Variants during Lamivudine Therapy for Patients with Chronic Hepatitis B

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YMDD variants of hepatitis B virus (HBV) emerge in some patients with chronic hepatitis B who receive lamivudine. YMDD variants were examined in 794 patients in 4 controlled studies of 1 year's duration. The long-term effects of YMDD variants were examined in a subset of patients treated up to 4 years. YMDD variants were detected by polymerase chain reaction (PCR) and restriction fragment-length polymorphism assays. After 1 year, YMDD variants were detected in 81 (24%) of 335 patients. In these patients, the median serum HBV DNA concentration at 1 year was <20% of the baseline level, and serum alanine transaminase (ALT) levels and liver histologic findings had significantly improved. In patients with YMDD variants who were treated for up to 4 years, median HBV DNA and ALT levels showed improvements. Sex, baseline body mass index, and HBV DNA level were associated with emergence of YMDD variants. Patients with YMDD variants losing clinical response with a significant increase in the HBV DNA and ALT levels may require additional therapy.

Journal Article.  5266 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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