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Basic Characteristics of Mutations
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Mutation Site
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M204V |
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Mutation Site Sentence
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Lamivudine-resistant HBV strain rtM204V/I in Acute hepatitis B. |
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Mutation Level
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Amino acid level |
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Mutation Type
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Nonsynonymous substitution |
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Gene/Protein/Region
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RT |
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Standardized Encoding Gene
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P
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Genotype/Subtype
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D |
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Viral Reference
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-
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Functional Impact and Mechanisms
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Disease
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Acute Hepatitis B
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Immune
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- |
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Target Gene
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-
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Clinical and Epidemiological Correlations
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Clinical Information
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- |
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Treatment
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Lamivudine(LAM) |
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Location
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Italy |
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Literature Information
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PMID
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23796869
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Title
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Lamivudine-resistant HBV strain rtM204V/I in acute hepatitis B
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Author
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Coppola N,Tonziello G,Colombatto P,Pisaturo M,Messina V,Moriconi F,Alessio L,Sagnelli C,Cavallone D,Brunetto M,Sagnelli E
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Journal
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The Journal of infection
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Journal Info
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2013 Oct;67(4):322-8
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Abstract
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AIMS: To detect HBV rtM204V/I lamivudine-resistant strains in serum of patients with acute hepatitis B and to assess their biological and clinical significance. METHODS: Eighty HBV DNA-positive patients with symptomatic acute hepatitis B observed from 1999 to 2010 were enrolled. A plasma sample obtained at the first observation was tested for HBV mutants in the polymerase region by direct sequencing; the antiviral drug-resistant rtM204V/I mutations, the most frequent HBV mutants in Italy, were also sought by the more sensitive allele-specific polymerase chain reaction (PCR). RESULTS: No HBV mutation associated with resistance to nucleos(t)ide analogues was identified by direct sequencing, whereas allele-specific PCR identified HBV strains carrying the substitution rtM204V/I in 11 (13.7%) patients. Compared with those with the HBV wild strain, patients with rtM204V/I more frequently showed severe acute hepatitis B (36.4% vs 8.7%; p < 0.05) and lower values of serum HBV DNA (1.77 x 10(6) +/- 4.76 x 10(6) vs. 1.68 x 10(8) +/- 5.46 x 10(8)). In addition, a multivariate analysis identified the presence of a pre-existing HCV chronic infection as independently associated with severe acute hepatitis B (p < 0.05). CONCLUSIONS: HBV rtM204V/I lamivudine-resistant strains were detected in serum of 11 (13.7%) patients with acute hepatitis B by allele-specific polymerase chain reaction. The frequent association of rtM204V/I with a more severe acute hepatitis B and with a lower viral load may suggest that greater and/or more prolonged immune pressure might have induced their selection.
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Sequence Data
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-
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