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

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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:

• 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]  
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