Prevalence of YMDD Variants Leading to Lamivudine Resistance among Chronic HBV Patients in Gaza Strip-Palestine

Abstract

Background: Hepatitis B is an inflammation of the liver caused by hepatitis B virus (HBV). It is widely spread in the world, so that there are a variety of antiviral drugs for HBV,. In Gaza strip the most commonly used anti- HBV drug is lamivudine. Long term use of lamivudine causes mutations; the most common mutations worldwide are rtM204 V/I/S and rt L180M. The aim of this study is to investigate the prevalence of lamivudine resistance among chronic patients in Gaza strip and to determine possible risk factors associated with lamivudine resistance. Materials and Methods: During this study all patients attending the medical centers in Gaza Strip (100 patients) were tested for viral load using Real Time Polymerase Chain Reaction (RT-PCR). Fiftyfour chronic hepatitis B patients with viral load above 4500 IU/mLwere included in the study. Lamivudine resistance for these patients was detected via RT-PCR. Data on possible risk factors was completed by the researcher from medical records and from calling patients to insure proper data collection. Results: The prevalence of lamivudine resistance genotypes was divided in this study into five groups; the first group is the wild type (YMDD) it was found in (32.6%) of the study population, then YMDD mixed with YIDD was (41.3%), the third was YIDD alone it was found in (13%), the fourth YIDD / YVDD was (2.2%), the final group was YMDD / YIDD / YVDD patients (10.9%). In addition, No significant relationship between YMDD(Wild type), YIDD,YIDD/YVDD,YIDD/ YMDD, and (YMDD /YIDD/ YVDD) versus age, sex, lamivudine intake duration, and liver function tests (ALT & AST).While a significant relation was fond between these variables with viral load. As well as significance have seen in wild type and mutant type with lamivudine intake duration. Conclusion: Lamivudine resistance was detected among chronic hepatitis B patients, therefore, routine monitoring for such patients in Gaza strip is highly recommended.