Drug Resistance Mutations in the Polymerase Gene of Hepatitis B Virus in Three Generations of Patients with Chronic Hepatitis B

Abstract

Abstract Hepatitis B virus polymerase proofreading defects lead to frequent DNA mutations in the hepatitis B virus genome and treatment resistance. This research aimed to investigate drug-resistant mutations in three generations of chronic hepatitis B patients. Based on the inclusion criteria, 90 HBV patients in northeastern Iran were divided into three groups. HBV DNA, liver function tests, serological markers, and liver stiffness measurements were also evaluated. Polymerase gene sequencing was used to identify mutations linked with resistance to NAs. P-values less than 0.05 were used to statistical significance. All samples were genotyped as genotype D/subtype ayw2. HBeAg was detected positive in 12.3% of samples, viral loads (P-value = 0.02) and LFT (P-value = 0.007) considerably higher than HBeAg-negative. YMDD, YINN and FLMAQ mutations were found in 26.7%, 4.5% and 5.5% of CHB patients, respectively. YIDD and FLIPH mutations occur together in 3.4% of three generations and 10% of two generations of patients. The three-generation group had a greater mean LSM (4.2 ± 1.6 KPa) than the other groups. Detection of mutations is critical for physicians to make decisions about antiviral medication selection and management. These results imply that polymerase resistance mutations in three and two generations of patients should be investigated before beginning the antiviral medication.