FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 354:1807-1812 April 27, 2006 Number 17 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

The reverse-transcriptase inhibitor lamivudine (Zeffix, GlaxoSmithKline) is often used to treat chronic infection with hepatitis B virus (HBV) until resistance develops. Treatment may then be switched to the reverse-transcriptase inhibitor adefovir (Hepsera, Gilead), which has a lower frequency of resistance. Here, we describe three cases of primary adefovir resistance that were sensitive to tenofovir (Viread, Gilead). All three cases involved a rare HBV variant with a valine at position 233 of the reverse-transcriptase domain instead of isoleucine (rtI233V), as in the wild-type virus. This HBV variant also displayed resistance to adefovir and sensitivity to tenofovir in vitro.

Source Information

From the Institute of Medical Microbiology and Immunology and the Department of Medicine I, University of Bonn, Bonn (O.S., J.K.R.); the Heinrich-Pette-Institut, Hamburg (H.S., A.F., C.O., H.W.); the Institute of Medical Virology, University of Giessen, Giessen (U.C.W., W.R.W., W.H.G.); the Practice for Gastroenterology and Hepatology, Herne (H.H.); and the Practice Abelein/Helm, Nuremberg (M.H.) — all in Germany.

Drs. Schildgen and Sirma contributed equally to the article. Drs. Will and Gerlich contributed equally to the article.

Address reprint requests to Dr. Gerlich at the Institute of Medical Virology, Frankfurterstr. 107, D 35392 Giessen, Germany, or at wolfram.h.gerlich{at}viro.med.uni-giessen.de.

Full Text of this Article

Related Letters:

Hepatitis B Virus with Primary Resistance to Adefovir
Chang T.-T., Lai C.-L., Schildgen O., Sirma H., Gerlich W.
Extract | Full Text | PDF  
N Engl J Med 2006; 355:322-323, Jul 20, 2006. Correspondence

This article has been cited by other articles:

• Malgarini, R. B., Pimpinella, G., Schildgen, O., Rodriguez-Torres, M., Hamzeh, F. (2009). Peginterferon Alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C. NEJM 360: 1907-1908 [Full Text]  
• Bottecchia, M., Madejon, A., Sheldon, J., Garcia-Samaniego, J., Barreiro, P., Soriano, V. (2008). Hepatitis B virus genotype A2 harbours an L217R polymorphism which may account for a lower response to adefovir. J Antimicrob Chemother 62: 626-627 [Full Text]  
• Schildgen, O., Shaw, T., Warner, N. (2007). Novel Lamivudine Resistance. Antimicrob. Agents Chemother. 51: 4533-4534 [Full Text]  
• Sirma, H., Funk, A., Gerlich, W., Schildgen, O. (2007). Does pre-treatment with lamivudine prime for adefovir resistance of hepatitis B virus infection?. J Antimicrob Chemother 60: 448-449 [Full Text]  
• Matthes, E., Funk, A., Krahn, I., Gaertner, K., von Janta-Lipinski, M., Lin, L., Will, H., Sirma, H. (2007). Strong and Selective Inhibitors of Hepatitis B Virus Replication among Novel N4-Hydroxy- and 5-Methyl-{beta}-L-Deoxycytidine Analogues. Antimicrob. Agents Chemother. 51: 2523-2530 [Abstract] [Full Text]  
• Laoi, B. N., Herra, C., Norris, S., Crowley, B. (2007). Hepatitis B virus resistance to adefovir in a nucleotide naive patient with chronic hepatitis B virus infection. J Antimicrob Chemother 59: 807-809 [Full Text]  
• Chang, T.-T., Lai, C.-L., Schildgen, O., Sirma, H., Gerlich, W. (2006). Hepatitis B virus with primary resistance to adefovir.. NEJM 355: 322-323 [Full Text]  
• (2006). Hepatitis B Virus Strains with Natural Adefovir Resistance. JWatch Infect. Diseases 2006: 7-7 [Full Text]