Study for relation between effect of anti-viral therapy and mutation of hepatitis B virus (HBV) in patients with chronic HBV infection.

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In the patients with chronic hepatitis B virus (HBV) infection, we studied the relation between HBV mutations and clinical or virologic characteristics, including response to anti-viral therapy. First of all, we investigated the clinical differences among different HBV genotypes. In the patients with HBV/B, the frequency of HBeAg was low compared with those with HBV/C. Core promoter mutations in the patients with HBV/C were more frequently found than in those with HBV/B. Secondary, we found that the strains with HBV/B should be divided into two subtype, HBV/Ba, which is ubiquitous in Asia, and HBV/Bj, which is unique in Japan. Finally, we compared the response to anti-viral therapy (lamivudine) and HBV mutation in 31 patients with HBV genotype B (HBV/B) and 31 patients with HBV/C whose gender and age were matched. The effect for lamivudine therapy were same among both HBV/B and HBV/C groups. The mutations of HBV polymerase gene were developed during therapy however the frequency of resistant strain were same among both genotypes group. The effect and development of lamivudine resistant strain during therapy were also same between HBV/Ba and HBV/Bj groups. There was no relation between the mutations of the core promoter region and efficacy for lamivudine therapy. These data suggested that the mutations of the HBV polymerase gene, not the core promoter region, is linked to the effect of lamivudine therapy.