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Article: Long-term follow-up study of Chinese patients with YMDD mutations: Significance of hepatitis B virus genotypes and characteristics of biochemical flares

TitleLong-term follow-up study of Chinese patients with YMDD mutations: Significance of hepatitis B virus genotypes and characteristics of biochemical flares
Authors
Issue Date2004
PublisherAmerican Society for Microbiology.
Citation
Journal Of Clinical Microbiology, 2004, v. 42 n. 9, p. 3932-3936 How to Cite?
AbstractWe sought to examine the role of hepatitis B virus (HBV) genotypes in virological breakthroughs and biochemical flares in patients with YMDD mutations during lamivedine therapy. Virologic breakthroughs (i.e., the reappearance of HBV DNA as determined by bDNA assay) and biochemical flares (mild flares = alanine aminotransferase [ALT] between 2 and 10 times the upper limit of normal [ULN]; severe flares = ALT > 10 times ULN) were monitored in 154 hepatitis B e antigen-positive patients receiving long-term lamivedine. The HBV genotypes and YMDD mutations were determined. Forty-three patients had virological breakthroughs with YMDD mutations (median follow-up of 29.6 months [range, 22.3 to 61.4]). Twenty patients (47%) patients had mild biochemical flares; seven (16%) had severe flares. Two patients showed an elevation of bilirubin level that is >2 times the ULN. All patients recovered spontaneously. The cumulative risks for biochemical flares were 28, 47, and 58% for the first 3 years, respectively. Patients with biochemical flares compared to those without flares had a significantly higher median pretreatment ALT level (61 U/liter versus 34.5 U/liter [P = 0.012]). There were no differences in the cumulative risk of virological breakthroughs, risk, and severity of biochemical flares between patients with genotypes B (n = 11) and C (n = 32). There was an increase in the percentage of patients with single YMDD mutant at last follow-up compared to that at the time of virological breakthroughs (74% [n = 32] versus 47% [n = 20], respectively; P = 0.015). The chances of YMDD mutations with virological breakthroughs and biochemical flares were similar in patients with genotypes B and C. Biochemical flares were common, with 16% being severe in nature. High pretreatment ALT levels were associated with a higher chance of biochemical flares.
Persistent Identifierhttp://hdl.handle.net/10722/49039
ISSN
2015 Impact Factor: 3.631
2015 SCImago Journal Rankings: 2.151
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorYuan, HJen_HK
dc.contributor.authorSablon, Een_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorWong, BCYen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2008-06-12T06:33:05Z-
dc.date.available2008-06-12T06:33:05Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of Clinical Microbiology, 2004, v. 42 n. 9, p. 3932-3936en_HK
dc.identifier.issn0095-1137en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49039-
dc.description.abstractWe sought to examine the role of hepatitis B virus (HBV) genotypes in virological breakthroughs and biochemical flares in patients with YMDD mutations during lamivedine therapy. Virologic breakthroughs (i.e., the reappearance of HBV DNA as determined by bDNA assay) and biochemical flares (mild flares = alanine aminotransferase [ALT] between 2 and 10 times the upper limit of normal [ULN]; severe flares = ALT > 10 times ULN) were monitored in 154 hepatitis B e antigen-positive patients receiving long-term lamivedine. The HBV genotypes and YMDD mutations were determined. Forty-three patients had virological breakthroughs with YMDD mutations (median follow-up of 29.6 months [range, 22.3 to 61.4]). Twenty patients (47%) patients had mild biochemical flares; seven (16%) had severe flares. Two patients showed an elevation of bilirubin level that is >2 times the ULN. All patients recovered spontaneously. The cumulative risks for biochemical flares were 28, 47, and 58% for the first 3 years, respectively. Patients with biochemical flares compared to those without flares had a significantly higher median pretreatment ALT level (61 U/liter versus 34.5 U/liter [P = 0.012]). There were no differences in the cumulative risk of virological breakthroughs, risk, and severity of biochemical flares between patients with genotypes B (n = 11) and C (n = 32). There was an increase in the percentage of patients with single YMDD mutant at last follow-up compared to that at the time of virological breakthroughs (74% [n = 32] versus 47% [n = 20], respectively; P = 0.015). The chances of YMDD mutations with virological breakthroughs and biochemical flares were similar in patients with genotypes B and C. Biochemical flares were common, with 16% being severe in nature. High pretreatment ALT levels were associated with a higher chance of biochemical flares.en_HK
dc.format.extent386 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherAmerican Society for Microbiology.en_HK
dc.relation.ispartofJournal of Clinical Microbiologyen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.rightsJournal of Clinical Microbiology. Copyright © American Society for Microbiology.en_HK
dc.rightsCopyright © American Society for Microbiology, Journal of Clinical Microbiology, 2004, v. 42 n. 9, p. 3932-3936en_HK
dc.subject.meshHepatitis B - drug therapy - geneticsen_HK
dc.subject.meshHepatitis B virus - geneticsen_HK
dc.subject.meshLamivudine - therapeutic useen_HK
dc.subject.meshMutation, Missense - geneticsen_HK
dc.subject.meshRNA-Directed DNA Polymerase - geneticsen_HK
dc.titleLong-term follow-up study of Chinese patients with YMDD mutations: Significance of hepatitis B virus genotypes and characteristics of biochemical flaresen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0095-1137&volume=42&issue=9&spage=3932&epage=3936&date=2004&atitle=Long-term+follow-up+study+of+Chinese+patients+with+YMDD+mutations:+significance+of+hepatitis+B+virus+genotypes+and+characteristics+of+biochemical+flaresen_HK
dc.identifier.emailYuen, MF:mfyuen@hkucc.hku.hken_HK
dc.identifier.emailWong, DKH:danywong@hku.hken_HK
dc.identifier.emailWong, BCY:bcywong@hku.hken_HK
dc.identifier.emailLai, CL:hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1128/JCM.42.9.3932-3936.2004en_HK
dc.identifier.pmid15364971-
dc.identifier.pmcidPMC516364en_HK
dc.identifier.scopuseid_2-s2.0-4644235700en_HK
dc.identifier.hkuros101400-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-4644235700&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume42en_HK
dc.identifier.issue9en_HK
dc.identifier.spage3932en_HK
dc.identifier.epage3936en_HK
dc.identifier.isiWOS:000223902000004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.scopusauthoridYuan, HJ=7402446707en_HK
dc.identifier.scopusauthoridSablon, E=6603694538en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK

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