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Pathogenic and clinical characteristics of hepatitis B virus(HBV) pre-existing mutations related to adefovir dipivoxil(ADV)among ADV treatment-naive patients with chronic HBV infection

MAO Hai-fang,HU Ai-rong,JIANG Su-wen,DING Shi-xion,WENG Peng-jian, HU Yao-ren,LIANG Xiao-yue Ningbo No.2 Hospital,Ningbo,Zhejiang 315010,China  
Objective To understand the pathogenic and clinical characteristics of HBV pre-existing mutations related to ADV among ADV treatment-naive patients with chronic HBV infection.Methods The gene resistance mutations of HBV P region in 211 ADV treatment-naive patients were analyzed by gene sequencing,meanwhile the HBV genotypes as well as HBV serum markers and HBV DNA levels were also determined.All patients were divided into pre-existing mutation group and non-mutation group based on the above data.Results Out of 211 patients,9 were found to have pre-existing mutations related to ADV and 4 of them had ill-formed usage of other antiviral drugs except for ADV.rtN238T mutation was found to be the dominant one(44.44%),and multi-sites mutation(55.56%) and mutation co-existence with wild strain(88.89%) were also popular.The constituent ratios of males and end-stage liver diseases in pre-existing mutation group were higher than those in non-mutation group(P=0.013,0.001).The average age of patients was 45.9±10.5 years in pre-existing mutation group and 35.6±10.2 years old in non-mutation group(t=2.978,P= 0.003).There were no statistically significant differences of constituent ratio of HBeAg,HBV genotypes and HBV DNA levels between the two groups.Conclusions There may be some cases with pre-existing mutations in ADV treatment-naive patients,and these pre-existing mutations may be related to ill-formed usage of antiviral drugs.Male patients and patients with longer history of HBV infection are more likely to have pre-exist mutations.It is important for patients to accept normative antiviral treatment in order to prevent resistance and avoid salvage therapy.
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