The diagnosis and clinical impact of drug induced, treatment resistant mutations of hepatitis B virus (HBV) during nucleoside analogue therapy

The most important advancement in the treatment of chronic HBV infected patients who do not respond to interferon is the availability of oral nucleoside analogues such as lamivudine, adefovir dipivoxil and entecavir. These are effective drugs in suppressing HBV replication and are also well tolerated in most cases. Long-term treatment with nucleoside analogues, however, is associated with the selection of drug resistant mutations of HBV which greatly limits their clinical applicability. To be able to determine when modification of the initial treatment is necessary and to do it in an effective way, these mutatio…