Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 14, 2009; 15(6): 753-755
Published online Feb 14, 2009. doi: 10.3748/WJG.15.753
Hepatitis B virus mutations potentially conferring adefovir/tenofovir resistance in treatment-naive patients
Rebecca Pastor, François Habersetzer, Samira Fafi-Kremer, Michel Doffoël, Thomas F Baumert, Jean-Pierre Gut, Françoise Stoll-Keller, Evelyne Schvoerer
Rebecca Pastor, Samira Fafi-Kremer, Jean-Pierre Gut, Françoise Stoll-Keller, Evelyne Schvoerer, Laboratoire de Virologie, CHRU de Strasbourg, 3 Rue Koeberlé, 67000 Strasbourg, France
Samira Fafi-Kremer, Thomas F Baumert, Jean-Pierre Gut, Françoise Stoll-Keller, Evelyne Schvoerer, Inserm U 748, Strasbourg, 3 Rue Koeberlé, 67000 Strasbourg, France
François Habersetzer, Michel Doffoël, Thomas F Baumert, Service d’Hépato-gastroentérologie, Nouvel Hôpital Civil, 1 Place de l’Hôpital, 67091 Strasbourg, France
Samira Fafi-Kremer, Thomas F Baumert, Jean-Pierre Gut, Françoise Stoll-Keller, Evelyne Schvoerer, Université Louis Pasteur, Faculté de Médecine, 4 Rue Kirschleger, 67084 Strasbourg, France
Author contributions: Pastor R performed the experiments, analyzed the data and wrote the manuscript; Habersetzer F, Doffoël M and Baumert TF contributed to the manuscript writing as experts in Hepato-gastroenterology and in viral hepatitis field; Fafi-Kremer S, Gut JP and Stoll-Keller F contributed to the virological analyses; Schvoerer E conducted the study and wrote the manuscript.
Correspondence to: Dr. Evelyne Schvoerer, Institut de Virologie, 3 Rue Koeberlé, 67000 Strasbourg, France. evelyne.schvoerer@chru-strasbourg.fr
Telephone: +33-390243696
Fax: +33-390243750
Received: September 26, 2008
Revised: December 17, 2008
Accepted: December 24, 2008
Published online: February 14, 2009
Abstract

Anti-hepatitis B virus (HBV) therapy leads to the emergence of mutant viral strains during the treatment of chronic hepatitis B with nucleos(t)ides analogues. The existence of HBV variants with primary antiviral resistance may be important for treatment choice. We studied two patients with chronic HBV infection by sequencing the HBV polymerase gene. They had adefovir- and tenofovir-related mutations in the viral polymerase, although they had never been treated. These mutations were rtV214A/rtN238T in one patient and rtA194T in the other. Thus, mutations in untreated patients deserve cautious surveillance. These data indicate that mutations that can theoretically confer adefovir or tenofovir resistance may emerge in treatment-naive patients.

Keywords: Hepatitis B virus, Viral polymerase mutations, Treatment-naive patients