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Lai X, Chen W, Wu Y, Gao Y, Zhang Y, Xu X, Fu Y, Wang X, Yang Y, Zhang Y. Effect of mutations across reverse transcriptase region on HBV replication and progression of liver diseases in Chinese patients. J Clin Lab Anal 2022; 36:e24530. [PMID: 35657116 PMCID: PMC9279987 DOI: 10.1002/jcla.24530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 11/06/2022] Open
Abstract
It was known that mutations in the RT region were mainly related to nucleot(s)ide analogs resistance. Increasing studies indicated that RT mutations were related to advanced liver diseases (ALD) and had effects on HBV replication, but the distribution characteristics of mutations across RT region in the development of liver diseases and the effect of RT mutations on HBV replication were not fully clarified. HBV RT region was direct-sequenced in 1473 chronic HBV-infected patients. Mutation frequencies were analyzed to identify the specific mutations differing between groups classified by genotypes, loads of HBV DNA, or progression of liver diseases. In the range of rt145-rt290, rt145, rt221, rt222, rt267, and rt271 were the genotype-polymorphic sites, while rt238 was the genotype-specific sites. Mutations at rt163, rt173, rt180, rt181, rt184, rt191, rt199, and rt214 were more frequent among patients with C-genotype HBV, while those at rt220, rt225, rt226, rt269, and rt274 were more frequent among patients with B-genotype HBV. RtM204V/I could reduce the HBV DNA loads while rtQ/L267H/R could increase the HBV DNA loads. RtV214A/E/I (OR 3.94, 95% CI 1.09 to 14.26) was an independent risk factor for advanced liver diseases. In summary, the hotspots of mutations were different between B and C genotypes. Besides the effect on the S region, RT mutations had effects on HBV replication by other unknown ways. RtV214A/E/I was found to be an independent risk factor for ALD, suggesting that mutations at rt214 site could be used as a potential virological marker for the liver disease progression.
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Affiliation(s)
- Xiaoqin Lai
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Wenfa Chen
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yuzhu Wu
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yali Gao
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Yalan Zhang
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Xuwei Xu
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
| | - Ya Fu
- Department of Clinical LaboratoryThe First Affiliated Hospital of Fujian Medical UniversityFuzhouChina
| | - Xinwen Wang
- Department of OrthopedicsSouthern Medical UniversityGuangzhouChina
| | - Yanbing Yang
- Department of ImagingMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Yin Zhang
- Pharmacy DepartmentThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhouChina
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2
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Xu R, Song D, Wang M, Huang J, Liao Q, Shan Z, Rong X, Fu Y. Molecular Epidemiological Characteristics and Risk Factors for Acquiring HBV Among Li Ethnic in Baisha County, Hainan Island-Subgenotype D3 Was First Discovered in China. Front Microbiol 2022; 13:837746. [PMID: 35197959 PMCID: PMC8859303 DOI: 10.3389/fmicb.2022.837746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/14/2022] [Indexed: 12/02/2022] Open
Abstract
The residents of Baisha, a county of Hainan Island, mainly composed of Li ethnic population and relatively closed living environment with its unique geographical location. Our previous study showed that Li ethnic population of Baisha is an endemic center for hepatitis C virus, with significantly higher rates than in other parts of China. However, the epidemiology of HBV in this region remains unclear. Therefore, we conducted a comprehensive epidemiological survey of HBV in Baisha County, including 1,682 Li ethnic residents. The total seropositive rate for HBsAg was 10.2% and was higher than other parts of China. HBV-positive status was associated with the 20–40-year-old group (OR = 1.27, 95%CI 1.04–1.39, P < 0.01) and alcohol consumption (OR = 2.17, 95%CI 1.58–2.99, P < 0.01). Phylogenetic analysis showed that HBV subgenotype D3 was predominant in Baisha County which was first discovered in China, followed by C5, C1, B2, and undetermined subgenotypes which were significantly different from other geographical distribution of main genotypes in China. The most recent common ancestor (tMRCA) of the HBV genotype C in the Li ethnic of Baisha County was 1846 (95%CI: 1739–1932), and Baisha-C5 was earlier than Baisha-C1 and Baisha-C2. Most Baisha-D3 sequences were concentrated in one bundle and unrelated to those D3 genome sequences elsewhere in the world. According to the phylogenetic tree, D3 was introduced into Baisha County in 1884 (95%CI: 1816–1993) and became a local endemic virus. In conclusion, HBV infection in the Li ethnic group is characterized by a high prevalence rate in 20–40-year-old individuals and a unique genotype distribution which were significantly different from other geographical distribution of main genotypes in China, and subgenotype D3 was first discovered in China.
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Affiliation(s)
- Ru Xu
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
| | - Dandan Song
- Department of Clinical Laboratory, The Fifth People’s Hospital of Zhuhai, Zhuhai, China
| | - Min Wang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
| | - Jieting Huang
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
| | - Qiao Liao
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
| | - Zhengang Shan
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
| | - Xia Rong
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- *Correspondence: Xia Rong,
| | - Yongshui Fu
- Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China
- The Key Medical Laboratory of Guangzhou, Guangzhou, China
- School of Laboratory Medicine and Biotechnology, Southern Medical University, Guangzhou, China
- Zhujiang Hospital of Southern Medical University, Guangzhou, China
- Yongshui Fu,
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Zou W, Qian F, Jin F, Li D, Chen J. Characterization of mutations in the reverse transcriptase region of hepatitis B virus in treated and untreated chronic hepatitis B patients. Trans R Soc Trop Med Hyg 2021; 115:870-877. [PMID: 33236067 DOI: 10.1093/trstmh/traa142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/19/2020] [Accepted: 11/06/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The reverse transcriptase (RT) region of the hepatitis B virus (HBV) is the target of antiviral treatment. However, the discrepancy in RT mutations between nucleos(t)ide analogue (NA)-treated and -untreated chronic hepatitis B (CHB) patients is un clear. METHODS Serum samples were collected from 119 NA-treated and 135 NA-untreated patients. The sampling time was decided by the clinician. Full-length HBV RT regions were amplified using nest polymerase chain reaction. The mutations within the RT region were analysed by direct sequencing. RESULTS The incidence of RT mutations in treated patients was higher than that in untreated patients (p<0.05). The classic drug-resistant mutations were detected in 44.5% (53/119) of treated patients, which was significantly higher than in untreated patients (6.7% [9/135]) (p<0.05). The non-classical mutations showed their complexity and diversity in both patient groups. Multiple mutations (three or more) were more frequent in treated patients than in untreated patients (p<0.05). Several novel mutations might be related to NA resistance. CONCLUSIONS The selection pressures of NAs accelerated the development of RT mutations, especially within the functional domain. Mutations in the RT region occurred not only at classical sites, but also at other non-classical sites, which might be related to drug resistance and/or viral replication. The biological function and fitness of HBV isolates harbouring these novel mutations need further in vitro and in vivo verification experiments.
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Affiliation(s)
- Weihua Zou
- Department of Laboratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China
| | - Fuchu Qian
- Department of Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China.,Huzhou Key Laboratory of Molecular Medicine, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China
| | - Fang Jin
- Department of Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China.,Huzhou Key Laboratory of Molecular Medicine, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China
| | - Dongli Li
- Department of Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China.,Huzhou Key Laboratory of Molecular Medicine, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China
| | - Jing Chen
- Department of Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China.,Huzhou Key Laboratory of Molecular Medicine, 1558 Sanhuan North Road, Huzhou, Zhejiang Province, China
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Mokaya J, Vasylyeva TI, Barnes E, Ansari MA, Pybus OG, Matthews PC. Global prevalence and phylogeny of hepatitis B virus (HBV) drug and vaccine resistance mutations. J Viral Hepat 2021; 28:1110-1120. [PMID: 33893696 PMCID: PMC8581767 DOI: 10.1111/jvh.13525] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/08/2021] [Indexed: 12/29/2022]
Abstract
Vaccination and anti-viral therapy with nucleos(t)ide analogues (NAs) are key approaches to reducing the morbidity, mortality and transmission of hepatitis B virus (HBV) infection. However, the efficacy of these interventions may be reduced by the emergence of drug resistance-associated mutations (RAMs) and/or vaccine escape mutations (VEMs). We have assimilated data on the global prevalence and distribution of HBV RAMs/VEMs from publicly available data and explored the evolution of these mutations. We analysed sequences downloaded from the HBV Database and calculated prevalence of 41 RAMs and 38 VEMs catalogued from published studies. We generated maximum likelihood phylogenetic trees and used treeBreaker to investigate the distribution and estimated the age of selected mutations across tree branches. RAM M204I/V had the highest prevalence, occurring in 3.8% (109/2838) of all HBV sequences in our data set, and a significantly higher rate in genotype C at 5.4% (60/1102, p = 0.0007). VEMs had an overall prevalence of 1.3% (37/2837) and had the highest prevalence in genotype C and in Asia at 2.2% (24/1102; p = 0.002) and 1.6% (34/2109; p = 0.009), respectively. Phylogenetic analysis suggested that RAM/VEMs can arise independently of treatment/vaccine exposure. In conclusion, HBV RAMs/VEMs have been found globally and across genotypes, with the highest prevalence observed in genotype C. Screening for genotype and for resistance-associated mutations may help to improve stratified patient treatment. As NAs and HBV vaccines are increasingly being deployed for HBV prevention and treatment, monitoring for resistance and advocating for better treatment regimens for HBV remains essential.
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Affiliation(s)
| | - Tetyana I. Vasylyeva
- Division of Infectious Diseases & Global Public HealthDepartment of MedicineUniversity of CaliforniaSan DiegoCAUSA
| | - Eleanor Barnes
- Nuffield Department of MedicineOxfordUK
- Department of HepatologyOxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxfordUK
- National Institutes of Health Research Health Informatics CollaborativeNIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
| | - M. Azim Ansari
- Nuffield Department of MedicineOxfordUK
- Wellcome Centre for Human GeneticsOxfordUK
| | | | - Philippa C. Matthews
- Nuffield Department of MedicineOxfordUK
- National Institutes of Health Research Health Informatics CollaborativeNIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Department of Infectious Diseases and MicrobiologyOxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxfordUK
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5
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Fu Y, Wu S, Hu Y, Chen T, Zeng Y, Liu C, Ou Q. Mutational characterization of HBV reverse transcriptase gene and the genotype-phenotype correlation of antiviral resistance among Chinese chronic hepatitis B patients. Emerg Microbes Infect 2021; 9:2381-2393. [PMID: 33124952 PMCID: PMC7605321 DOI: 10.1080/22221751.2020.1835446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background and Aims: The drug resistance of hepatitis B virus (HBV) originates from mutations within HBV reverse transcriptase (RT) region during the prolonged antiviral therapy. So far, the characteristics of how these mutations distribute and evolve in the process of therapy have not been clarified yet. Thus we aimed to investigate these characteristics and discuss their contributing factors. Methods: HBV RT region was direct-sequenced in 285 treatment-naive and 214 post-treatment patients. Mutational frequency and Shannon entropy were calculated to identify the specific mutations differing between genotypes or treatment status. A typical putative resistance mutation rtL229V was further studied using in-vitro susceptibility assays and molecular modeling. Results: The classical resistance mutations were rarely detected among treatment-naive individuals, while the putative resistance mutations were observed at 8 AA sites. rtV191I and rtA181T/V were the only resistance mutations identified as genotype-specific mutation. Selective pressure of drug usage not only contributed to the classical resistance mutations, but also induced the changes at a putative resistance mutation site rt229. rtL229V was the major substitution at the site of rt229. It contributed to the most potent suppression of viral replication and reduced the in-vitro drug susceptibility to entecavir (ETV) when coexisting with rtM204V, consistent with the hypothesis based on the molecular modeling and clinical data analysis. Conclusions: The analysis of mutations in RT region under the different circumstances of genotypes and therapy status might pave the way for a better understanding of resistance evolution, thus providing the basis for a rational administration of antiviral therapy.
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Affiliation(s)
- Ya Fu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
| | - Songhang Wu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
| | - Yuhai Hu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Tianbin Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
| | - Yongbin Zeng
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
| | - Can Liu
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
| | - Qishui Ou
- Department of Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Clinical Laboratory Diagnostics, The First Clinical College, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.,Gene Diagnosis Research Center, Fujian Medical University, Fuzhou, China
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6
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Liu Y, Wu C, Chen R, Li X, Xu Z, Li Q, Li L, Wang FS, Yang D, Lu M, Xu D. Molecular cloning and phenotypic analysis of drug-resistance mutants with relevant S-region variants of HBV for a patient during 189-month anti-HBV treatment. Antivir Ther 2020; 24:237-246. [PMID: 30882363 DOI: 10.3851/imp3305] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A unique chronic hepatitis B patient was followed over 189 months of nucleoside/nucleotide analogue (NA) therapies with the analysis of multiple drug-resistance HBV mutants. METHODS Clonal sequencing (≥20 clones/sample) was performed on sera sampled at 41 time points, and the phenotypic features of eight representative mutants were analysed. RESULTS Lamivudine (LAM)-, adefovir dipivoxil (ADV)-, entecavir (ETV)- and repeat ADV-resistance mutants emerged upon individual sequential NA monotherapy. The efficacy of NA combination rescue therapies ranked as LAM+ADV < ETV+ADV < ETV+ tenofovir disoproxil fumarate (TDF). Specifically, LAM+ADV and ETV+ADV suppressed viral loads to <100 IU/ml for a long period of time, either with or without late stage HBV DNA fluctuations. Furthermore, ETV+TDF suppressed the viral load to <10 IU/ml. During the LAM+ADV and ETV+ADV combination therapies, ETV-resistance mutants dominated at most time points, and multidrug-resistance (MDR) mutants that harboured LAM-, ETV- and ADV-resistance mutations were intermittently detected. Interestingly, the rtA181T-causative sW172stop to sW172non-stop mutation transition was observed at HBV DNA fluctuations. In a phenotypic analysis, two MDR strains had cross-resistance to LAM, ETV and ADV, and a lower susceptibility to TDF (<10-fold decrease compared with the wild-type strain). In contrast, the natural replication capacity was inversely associated with the number of primary resistant mutations which would limit MDR mutant development. CONCLUSIONS Taken together, viral drug susceptibility, replication capacity, and perhaps immunological adaptation may play coordinated roles in the fitness of drug-resistance mutants. ETV+TDF therapy is the preferred option for treating chronic hepatitis B patients with multiple drug failure.
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Affiliation(s)
- Yan Liu
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Chunchen Wu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Rongjuan Chen
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Xiaodong Li
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Zhihui Xu
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Qi Li
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Le Li
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Fu-Sheng Wang
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - Dongliang Yang
- Department of Infectious Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengji Lu
- Institute of Virology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Dongping Xu
- Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China
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7
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Gao J, Zuo R, Wang J, Shen T. Characteristics and evolutionary history of hepatitis B virus quasi-subgenotype B3 in Southeast Asia. Virus Res 2019; 273:197762. [PMID: 31541667 DOI: 10.1016/j.virusres.2019.197762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 09/17/2019] [Accepted: 09/17/2019] [Indexed: 12/16/2022]
Abstract
To analyze the hepatitis B virus (HBV) quasi-subgenotype B3 characters and molecular evolution in Southeast Asia, 411 serum samples with HBsAg positive were collected from Xishuangbanna, China. After DNA extraction, PCR amplification and sequencing, a total of 183 HBV full-length genomes were obtained. Phylogenetic analysis showed 139 stains (76.0%) were genotype B, 41 strains were genotype C (22.4%) and 3 strains were genotype I (1.6%). Among genotype B, 34 sequences were identified as quasi-subgenotype B3. Quasi-subgenotype B3 sequences from this study and quasi-subgenotype B3 sequences from the GenBank (total of 141 complete genome sequences) were grouped into quasi-subgenotype B3 (B3, formerly B5, Chinese B6 and B7-9). Sixteen peculiar nucleotides distributed in quasi-subgenotype B3 were identified, which were differ from B1, B2, B4 and B5(formerly B6) (nt93 T, nt100C, nt355 G, nt843 T, nt861C, nt912C, nt929 T, nt930 G, nt1023 T, nt1041 T, nt2651C, nt2693 T, nt2970C, nt3054A, nt3087A and nt3171 G). Then Evolutionary dynamics analysis of HBV quasi-subgenotype B3 was performed. The mean rate of nucleotide substitution for HBV quasi-subgenotype B3 was estimated to be around 5.556-5.660 × 10-4 substitutions/site/year. Estimated time to most recent ancestor of quasi-subgenotype B3 was around the 1847-1945(95%HPD), and Yunnan strains might be the parental strains. The Bayesian sky plot showed a steady spreading of HBV quasi-genotype B3 from early of 1940s to 90 s. In summary, HBV quasi-subgenotype B3 infection is prevalent in Southeast Asia based on the current reports and still with a high prevalence rate based on the evolutionary dynamics analysis. Current vaccine and nucleotide analogues might have effective prevention and treatment for HBV quasi-subgenotype B3 based on the rare clinically relevant mutation sites included in quasi-subgenotype B3.
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Affiliation(s)
- Jianmei Gao
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology, Key Laboratory for Birth Defects and Genetic Diseases, the First People's Hospital of Yunnan Province, Kunming, China
| | - Rongxia Zuo
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology, Key Laboratory for Birth Defects and Genetic Diseases, the First People's Hospital of Yunnan Province, Kunming, China
| | - Jinli Wang
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology, Key Laboratory for Birth Defects and Genetic Diseases, the First People's Hospital of Yunnan Province, Kunming, China
| | - Tao Shen
- Institute of Basic and Clinical Medicine, Yunnan Provincial Key Laboratory for Clinical Virology, Key Laboratory for Birth Defects and Genetic Diseases, the First People's Hospital of Yunnan Province, Kunming, China.
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8
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Liu Y, Zhou Y, Li X, Niu M, Chen R, Shao J, Si L, Luo D, Lin Y, Li L, Zhang K, Xiao X, Xu Z, Liu M, Lu M, Zoulim F, Xu D. Hepatitis B virus mutation pattern rtL180M+A181C+M204V may contribute to entecavir resistance in clinical practice. Emerg Microbes Infect 2019; 8:354-365. [PMID: 30866789 PMCID: PMC6455135 DOI: 10.1080/22221751.2019.1584018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background and Aims: Entecavir (ETV) resistance of hepatitis B virus (HBV) conventionally requires rt184, 202, or 250 mutations plus lamivudine-resistance mutation (rtM204V/I ± L180M). This study aimed to clarify whether rtL180M+A181C+M204V mutations may contribute to HBV ETV resistance. Methods: Serum samples were collected from 22,009 patients who underwent resistance testing in Beijing 302 Hospital from 2007 to 2016. HBV reverse transcriptase (RT) gene was screened by direct sequencing and verified by clonal sequencing. Phenotypic analysis was performed for evaluating replication capacity and drug susceptibility. Results: Classical ETV-resistance mutations of HBV were detected in 1252 patients who were receiving ETV therapy. The rtA181C mutation was detected with rtL180M+M204V mutations in 18 lamivudine-experienced ETV-treated patients, and the emergence of the mutations was associated with virological breakthrough or inadequate virological response to ETV. Patient-derived representative rtA181C-containing mutants, rtL180M+A181C+M204V, rtL180M+A181C+M204V+M250V, and rtL180M+A181C+S202G+M204V, exhibited 45.7%, 25.9%, and 25.0% replication capacity and 85.6-, 356.1-, and 307.1-fold decreased susceptibility to ETV respectively compared to the wild-type strain, while the three mutants remained sensitive to tenofovir (TDF). Artificial elimination of rtA181C largely restored the rtL180M+A181C+M204V mutant’s sensitivity to ETV. Molecular modelling of viral RT binding to ETV showed that the rtL180M+A181C+M204V mutant had a less stable conformation compared to rtL180M+M204V mutant. In clinical practice, undetectable serum HBV DNA was achieved in two of five longitudinally followed rtA181C-positive patients who received switching-to TDF therapy, but not in the other three who received add-on adefovir therapy during observation. Conclusions: Both clinical and experimental data support rtL180M+A181C+M204V as a novel non-classical ETV-resistance mutation pattern.
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Affiliation(s)
- Yan Liu
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Yi Zhou
- b Department of Infectious Diseases , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Xiaodong Li
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Ming Niu
- c Institute of Chinese Medicine , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Rongjuan Chen
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Jinman Shao
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Lanlan Si
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Dan Luo
- b Department of Infectious Diseases , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Yayun Lin
- b Department of Infectious Diseases , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Le Li
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Kai Zhang
- b Department of Infectious Diseases , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Xiaohe Xiao
- c Institute of Chinese Medicine , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Zhihui Xu
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
| | - Min Liu
- b Department of Infectious Diseases , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Mengji Lu
- d Institute of Virology , University Hospital of Essen, University of Duisburg-Essen , Essen , Germany
| | - Fabien Zoulim
- e Univ Lyon, Universite Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Leon Berard, Centre de recherche en cancerologie de Lyon , Lyon , France.,f Department of Hepatology, Groupement Hospitalier Nord , Hospices Civils de Lyon , Lyon , France
| | - Dongping Xu
- a Institute of Infectious Diseases , Beijing 302 Hospital , Beijing , People's Republic of China
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9
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Littlejohn M. Antiviral drug resistance and hepatitis B: a continuing public health problem. Antivir Ther 2019; 22:643-644. [PMID: 28504241 DOI: 10.3851/imp3176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2017] [Indexed: 10/19/2022]
Abstract
The use of selective antiviral therapy has been very successful in controlling HBV replication in individuals, leading to a reduction in disease progression and mortality. However, the use of first-generation therapies, often the only available option in low-resource settings, can result in a high prevalence of drug resistance mutations. Variants selected by antiviral therapies targeting the viral polymerase can also result in variants in the viral envelope. These variants can allow the virus to escape the host immune response. The effect of antiviral selection pressure on viral variants that may contribute to immune escape requires further investigation.
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Affiliation(s)
- Margaret Littlejohn
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
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10
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Guo X, Wu J, Wei F, Ouyang Y, Li Q, Liu K, Wang Y, Zhang Y, Chen D. Trends in hepatitis B virus resistance to nucleoside/nucleotide analogues in North China from 2009-2016: A retrospective study. Int J Antimicrob Agents 2018; 52:201-209. [PMID: 29654894 DOI: 10.1016/j.ijantimicag.2018.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022]
Abstract
Nucleos(t)ide analogues (NAs) are widely used in anti-hepatitis B virus (anti-HBV) therapy for effective inhibition of HBV replication. However, HBV resistance to NAs has emerged, resulting in virus reactivation and disease recurrence. Data on the current dynamics of HBV resistance are still rare in China. This study analysed 4491 plasma samples with HBV primary genotypic resistance mutations representative of the general HBV resistance situation in northern China from 2009-2016. We found that entecavir (ETV), representing 57.6% (12 713/22 060) of NA users in North China in 2016, has become the major NA for treating Chinese patients infected with HBV. Despite >50% of M204I/V±L180M among all HBV resistance cases annually and extensive exposure of patients to lamivudine (LAM), telbivudine (LdT) and adefovir dipivoxil (ADV), ETV resistance also showed a dramatically increased incidence, which rose to 17.1% in 2016. Moreover, A181T/V, ETV resistance mutations and multidrug resistance mutations were found more frequently in HBV genotype C compared with genotype B (21.2% vs. 8.5%, 12.4% vs. 7.9% and 5.9% vs. 3.0%, respectively), whereas M204I and N236T were more predominant in genotype B than genotype C (40.3% vs. 20.8% and 11.3% vs. 1.8%, respectively). In conclusion, we report the dynamic changes of HBV NA resistance mutation patterns and the current NA usage profile for anti-HBV treatment in North China over the past 8 years. These data provide valuable information on HBV NA resistance that is an important reference for clinicians to devise more effective treatment regimens for individual patients.
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Affiliation(s)
- Xianghua Guo
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China
| | - Jushan Wu
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China
| | - Feili Wei
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China
| | - Yabo Ouyang
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China
| | - Qing Li
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China
| | - Kai Liu
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China
| | - Yanjun Wang
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China
| | - Yulin Zhang
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China.
| | - Dexi Chen
- Beijing You An Hospital, Capital Medical University, Beijing 100069, China; Beijing Institute of Hepatology, Beijing 100069, China; Beijing Precision Medicine and Transformation Engineering Technology Research Center of Hepatitis and Liver Cancer, Beijing 100069, China; Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Qingdao City, Shandong Province 266003, China.
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11
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Evolution of drug-resistant mutations in HBV genomes in patients with treatment failure during the past seven years (2010-2016). Virus Genes 2017; 54:41-47. [PMID: 29119303 DOI: 10.1007/s11262-017-1518-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023]
Abstract
The objective of this study was to analyze the prevalence of drug-resistant HBV mutants in patients with treatment failure during the past seven years (2010-2016). 4055 HBV-infected patients who underwent HBV polymerase gene mutation test from 2010 to 2016 were enrolled. The nucleos(t)ide analogues (NAs) resistance mutation positions, including rtL180, rtA181, rtT184, rtS202, rtM204, rtI233, rtN236, rtI169, rtV173, and rtM250 were analyzed. Genotypic resistance mutations were detected in 30.8% (1248/4055) of the patients with treatment failure. Rates of drug-resistant mutations associated with LAM, ADV, ETV, and multidrug were 27.23% (1104/4055), 9.67% (392/4055), 3.69% (150/4055), and 0.79% (32/4055). Among the primary NA-resistant mutations, rtM204I (13.44%, 545/4055) occurred more frequently, followed by rtM204V, rtN236T, rtA181T, and rtA181V. For single-base mutations, rtL180M and rtA181V increased gradually during the past seven years, while rtM204I/V and rtN236T decreased after 2015. The development of drug-resistant mutations positively correlated with the consumption of ETV (r = 0.964, P = 0.002), and weakly correlated with that of LAM (r = 0.679, P = 0.109) and ADV (r = 0.429, P = 0.354). Moreover, single-base mutation rtA181V and multi-base mutations (rtL180M + M204I and rtL180M + M204V + M204I) were more common in HBV genotype C than those in genotype B (1.94% vs. 0.66%, 1.84% vs. 0.16%, 1.02% vs. 0.16%, respectively). NA-related mutations in HBV RT region increased in the past seven years, especially for LAM. Frequencies of rtL180M and rtA181T/V increased gradually in the past seven years, to which we should pay more attention.
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12
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Wang J, Qiu J, Zhu Y, Zhou H, Yu L, Ding Y, Zhang L, Guo Z, Dong C. Molecular evolution of hepatitis B vaccine escape variants in China, during 2000-2016. Vaccine 2017; 35:5808-5813. [PMID: 28939157 DOI: 10.1016/j.vaccine.2017.09.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/02/2017] [Accepted: 09/08/2017] [Indexed: 02/07/2023]
Abstract
Hepatitis B vaccine escape variants are the main threat to hepatitis B virus (HBV) infection in vaccination era worldwide. With 215 genotype B HBV and 313 genotype C HBV vaccine escape variants isolated from China during 2000-2016, we reported that genotype B HBV vaccine escape strains diverged in ∼1997 (95% HPD; 1987-2005), while genotype C HBV vaccine escape strains diverged in ∼1976 (95% HPD; 1955-2003). Additionally, the p-distance of genotype C HBV vaccine escape strains was 0.0291±0.0169, which was significantly higher than that in the genotype B HBV (t=131.02, p<0.05). However, genotype B HBV vaccine escape strains evolved more rapidly than genotype C HBV (2.103×10-3 vs 1.083×10-3 substitutions/site/year). Bayesian skyline plot analysis showed that the populations of genotype C HBV vaccine escape strains fluctuated more than those in genotype B HBV. Four sites (A5T/S, L21S, T/A126S and T/N131I/A) and 13 sites (N3S, T5A, G10Q/R/E, L21S, T47K/A/V, L98V/P, I/S126N/V/T, Q129H/R/L, T131P/I/N/A, G145A/R, L175S/F, L213I/S, V224A/G) were found to be under positive selection in genotype B and C HBV vaccine escape strains, respectively. More importantly, N3S, L21S, T47K, L98V, I/S126T and L213I mutations were detected in 1 (2.5%), 1 (2.5%), 1 (2.5%), 3 (7.5%), 1 (2.5%), 1 (2.5%) genotype C HBV infected Chinese younger with neonatal HBV vaccination, respectively. Therefore, our results should be valuable in further understanding the molecular evolution of HBV and providing new ideas for the elimination of HBV infection.
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Affiliation(s)
- Jie Wang
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jing Qiu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yinwei Zhu
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Hui Zhou
- Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou 215123, China
| | - Lugang Yu
- Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou 215123, China
| | - Yi Ding
- Suzhou Industrial Park Centers for Disease Control and Prevention, Suzhou 215123, China
| | - Lige Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Zhirong Guo
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Chen Dong
- Department of Epidemiology and Statistics, School of Public Health, Jiangsu Key Laboratory and Translational Medicine for Geriatric Disease, Medical College of Soochow University, Suzhou, Jiangsu, China.
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Wang LP, Cheng X, Li CY, Dai MJ, Han FZ, Yan XB. Relationship between pre-existing resistance mutations and HBV genotype in patients with HBV related liver cirrhosis. Shijie Huaren Xiaohua Zazhi 2017; 25:891-896. [DOI: 10.11569/wcjd.v25.i10.891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the relationship between hepatitis B virus (HBV)-related drug resistance mutations and HBV genotype in patients with HBV-related liver cirrhosis (LC).
METHODS Serum samples were collected from 112 patients with HBV-related LC who did not receive prior anti-viral treatment. HBV reverse transcriptase regions were amplified by PCR, and PCR products were directly sequenced.
RESULTS Among 112 HBV-related LC patients, 13 (11.61%, 13/112) had lamivudine resistance associated mutations, 15 (13.39%, 15/112) had adefovir resistance associated mutations, and 1 had mutations associated with both lamivudine and adefovir resistance. All of these resistance mutations occurred in patients infected with HBV genotype C, and there was no mutation in patients infected with HBV genotype B.
CONCLUSION Adefovir/lamivudine resistance associated mutations exist in patients with HBV-related LC, and the mutations are related to HBV genotype. Compared with patients infected with HBV genotype B, those infected with HBV genotype C are prone to resistance mutations.
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