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Basic Characteristics of Mutations
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Mutation Site
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V519L |
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Mutation Site Sentence
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For patient 2, lamivudine resistance was associated with V519L and M550I. |
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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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P |
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Standardized Encoding Gene
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P
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Genotype/Subtype
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- |
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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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Hepatitis B Virus Infection
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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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Treatment
|
Lamivudine(LAM) |
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Location
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- |
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Literature Information
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PMID
|
10669360
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Title
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Selection of multiresistant hepatitis B virus during sequential nucleoside-analogue therapy
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Author
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Mutimer D,Pillay D,Cook P,Ratcliffe D,O'Donnell K,Dowling D,Shaw J,Elias E,Cane PA
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Journal
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The Journal of infectious diseases
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Journal Info
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2000 Feb;181(2):713-6
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Abstract
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Hepatitis B virus (HBV) drug resistance to lamivudine is always accompanied by mutations in the viral polymerase gene at position 550, termed group 1 (M550V with L526M) or group 2 (M550I) mutations. The latter mutation has not been associated with famciclovir resistance. Thus, the addition of famciclovir to lamivudine therapy in persons with group 2 lamivudine resistance may lead to virus suppression. The effect of lamivudine/famciclovir combination therapy on HBV infection was monitored in 5 lamivudine-resistant patients by quantitative polymerase chain reaction and polymerase gene sequencing of serum virus. No patients treated with combination therapy had a decline in HBV load >1 log10. Continual evolution of the viral polymerase was detected in association with virologic resistance to both drugs. Cloning experiments identified the preexistence of these multidrug-resistant virus variants as minority species prior to addition of famciclovir therapy. HBV resistance to lamivudine monotherapy is associated with a complex mixture of variants that limit the efficacy of second-line nucleoside-analogue therapy. First-line potent combination therapy may reduce the emergence of HBV drug resistance.
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Sequence Data
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-
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