https://scholars.lib.ntu.edu.tw/handle/123456789/568793
標題: | Hepatitis B virus variants in patients receiving lamivudine treatment with breakthrough hepatitis evaluated by serial viral loads and full-length viral sequences | 作者: | CHUN-JEN LIU PEI-JER CHEN Lai M.-Y. JIA-HORNG KAO DING-SHINN CHEN |
公開日期: | 2001 | 卷: | 34 | 期: | 3 | 起(迄)頁: | 583-589 | 來源出版物: | Hepatology | 摘要: | Both viral loads and genome variations have been implicated in the pathogenesis of acute exacerbation of chronic hepatitis B. Hepatitis B exacerbation in patients receiving lamivudine treatment represented a unique setting to clarify their importance. Three organ recipients with posttransplantation hepatitis B exacerbation and 3 patients with chronic hepatitis B were studied. All received lamivudine treatment and their alanine aminotransferase (ALT) levels and hepatitis B virus (HBV) loads were regularly followed. Full-length genomic sequences before and during lamivudine treatment were determined in patients who had breakthrough of serum HBV DNA or elevation of serum ALT. Breakthrough of serum HBV DNA occurred after 6 to 15 months of lamivudine treatment in all. A rapid increase of viral load accompanying the emergence of tyrosine-methionine-aspartate-aspartate (YMDD) variant was followed by hepatitis B exacerbation in each patient. The mean number of nucleotide and amino acid substitutions per genome pair was equivalent in immunosuppressed or immunocompetent patients (6.3 vs. 6.3 for nucleotide, P > .05; 6.0 vs. 6.7 for amino acid, P > .05). Changes of nucleotide and amino acid beyond the YMDD motif were distributed along the whole HBV genome but none occurred within the known B-cell epitopes and human leukocyte antigen class I- or II-restricted T-cell epitopes. Our results suggest that a resurgence of viral load rather than changes of the known immunogenic viral epitopes is more closely associated with the development of hepatitis B exacerbation after the emergence of YMDD variants in patients receiving lamivudine treatment. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84984548357&doi=10.1053%2fjhep.2001.27220&partnerID=40&md5=c9f1b34491198fa65ea60ec352b03a8d https://scholars.lib.ntu.edu.tw/handle/123456789/568793 |
ISSN: | 0270-9139 | DOI: | 10.1053/jhep.2001.27220 | SDG/關鍵字: | gene product; lamivudine; tyrosylmethionylaspartylaspartic acid; unclassified drug; virus DNA; adult; alanine aminotransferase blood level; amino acid substitution; article; chronic hepatitis; clinical article; controlled study; disease exacerbation; follow up; genome; hepatitis B; Hepatitis B virus; human; immunocompetence; immunogenicity; male; nucleotide sequence; pathogenesis; priority journal; protein motif; treatment outcome; viral genetics; virus load |
顯示於: | 臨床醫學研究所 |
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