Avtor/Urednik		Hermans, Lucas Etienne; Svicher, Valentina; Diepstraten Pas, Suzan; Salpin, Romina; Alvarez, Marta; Ben Ari, Ziv; Boland, Greet; Bruzzone, Bianca; Lunar, Maja M.; Poljak, Mario
Naslov		Combined analysis of the prevalence of drug-resistant hepatitis B virus in antiviral therapy-experienced patients in Europe (CAPRE)
Tip		članek
Vol. in št.		Letnik 213, št. 1
Leto izdaje		2016
Obseg		str. 39-48
ISSN		0022-1899 - The Journal of infectious diseases
Jezik		eng
Abstrakt		Background . European guidelines recommend treatment of chronic hepatitis B virus infection (CHB) with the nucleos(t)ide analogs (NAs) entecavir or tenofovir. However, many European CHB patients have been exposed to other NAs, which are associated with therapy failure and resistance. The CAPRE study was performed to gain insigh t in prevalence and characteristics of NA resistance in Europe. Methods . A survey was performed on genotypic resistance testing results acquired during routine monitoring of CHB patients with detectable serum hepatitis B virus DNA in European tertiary referral centers. Results . Data from 1568 patients were included. The majority (73.8%) were exposed to lamivudine monotherapy. Drug-resistant strains were detected in 52.7%. The most frequently encountered primary mutation was M204V/I (48.7%), followed by A181T/V (3.8%) and N236T (2.6%). In patients exposed to entecavir (n = 102), f ull resistance was present in 35.3%. Independent risk factors for resistance were age, viral load, and lamivudine exposure ( P < .001). Conclusions . These fi ndings support resistance testing in cases of apparent NA therapy failure. This survey highlights the impact of exposure to lamivudine and adefovir on development of drug resist ance and cross-resistance. Continued use of these NAs needs to be reconsidered at a pan-European level.
Proste vsebinske oznake		hepatitis B virus antiviral drug resistance genotypic resistance testing virus hepatitisa B protivirusna odpornost na zdravila testiranje genotipske odpornosti