This report aimed to analyze screening on mutations of resistance to drug in
hepatitis B virus (HBV) during patient treatment using 1amivudine and adefovir dipivoxil.
Methods A 40-year-old Chinese man presented to Chongqing Cancer Hospital, with
hepatitis B surface antigen-positive and HBeAg-positive chronic HBV and was sequentially
treated with LAM 100mg/d for 16 weeks, and LAM 50 mg/d + ADV 10mg/d for 16 weeks.
The primers P1(5′-AAGGGTATCTTGCCCGTTTGTCGTA-3′) P2(5′-AAGCAGGATAGCCACAGA-
3′) and P3(5′-AAGGCACTTGTATTCCCATCCGAG-3′) P4 (5′-AAGGTCTATTTACAGGGGA-
3′) was used to analyzed the RT region of the polymerase gene from the serum of
the patient at weeks 0, 18, 22, 60 and 70. Results The mutation M204V and T213T were
detected prior to treatment, At week 18 during LAM treatment, the mutation LMV rtH69T
(YMDDlocus) was identified, At week 22 during LAM treatment, the mutations LMV
rtT184T(YMDDlocus) and LMV rtM204I (YMDDlocus).At week 60 during LAM + ADV
treatment, the mutations ADV T213S0ADV T222A and ADV K212T were detected, at week
70 during LAM + ADV treatment, the mutations ADV S196L and ADV S242H were detected,
The mutations ADV S196L and ADV S242H were detected firstly.Conclusions The report
detected HBV mutations that escaped the antiviral pressure of LAM and LAM + ADV in
the patient and provided insight into the molecular mechanism of the drug resistance for
HBV virus.