Hoang Minh-Cong, Duong Hong-Quan, Le Van-Duyet, Nguyen Thi-Thuy-Nga, Ngo Van-Lang, Dang The-Hung
Laboratory Department, Yenphong Medical Center, Bacninh, Vietnam.
Laboratory Center, Hanoi University of Public Health, 1A Duc Thang, North Tu Liem, Hanoi 100000, Vietnam.
Ther Adv Infect Dis. 2025 Jun 14;12:20499361251344784. doi: 10.1177/20499361251344784. eCollection 2025 Jan-Dec.
Vietnam has one of the highest hepatitis B virus (HBV) infection rates, with approximately 8 million people affected. Although antiviral drug resistance mutations have been reported in treatment-naïve patients with chronic hepatitis B, there is limited data on primary drug resistance mutations in circulating genotypes within this population.
This study aimed to investigate primary antiviral drug resistance mutations and common HBV genotypes in treatment-naïve patients with chronic hepatitis B, particularly in cases without well-characterized resistance profiles.
A cross-sectional study.
We analyzed HBV genotypes and antiviral drug resistance mutations in 113 treatment-naïve patients with chronic hepatitis B in the Yenphong Medical Center, Bacninh Vietnam. The reverse transcriptase (RT) region of the HBV polymerase genes was sequenced to detect mutations.
Genotypes B, C, and G were identified in 85.0% (96/133), 14.1% (16/133), and 0.9% (1/133) of treatment-naïve patients with chronic hepatitis B, respectively. Mutations in the RT region associated with antiviral drug resistance were detected in 32.7% (37/113) of patients. In addition, the most frequent resistance mutations were rtV207M (89.2%, 33/37), followed by A194T, L180M + M204V, V173L + M204I + L80I, and A181T + V207M + A181T, each observed in 2.7% (1/37). Notably, no significant associations were found between resistance mutations and HBV genotype, gender, age, hepatitis B e-antigen status, baseline HBV DNA levels, or level of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase.
This study highlights the presence of primary resistance mutations in treatment-naïve patients and underscores the importance of genotypic screening prior to initiating therapy. These findings may inform treatment strategies and help reduce the risk of treatment failure, liver cirrhosis, and hepatocellular carcinoma.
越南是乙肝病毒（HBV）感染率最高的国家之一，约有800万人受到影响。尽管在未经治疗的慢性乙肝患者中已报道了抗病毒药物耐药性突变，但关于该人群中循环基因型的原发性耐药性突变的数据有限。
本研究旨在调查未经治疗的慢性乙肝患者中的原发性抗病毒药物耐药性突变和常见HBV基因型，特别是在耐药特征不明确的病例中。
一项横断面研究。
我们分析了越南北宁省延丰医疗中心113例未经治疗的慢性乙肝患者的HBV基因型和抗病毒药物耐药性突变。对HBV聚合酶基因的逆转录酶（RT）区域进行测序以检测突变。
在未经治疗的慢性乙肝患者中，分别有85.0%（96/133）、14.1%（16/133）和0.9%（1/133）的患者鉴定出B、C和G基因型。在32.7%（37/113）的患者中检测到与抗病毒药物耐药性相关的RT区域突变。此外，最常见的耐药性突变是rtV207M（89.2%，33/37），其次是A194T、L180M + M204V、V173L + M204I + L80I和A181T + V207M + A181T，各占2.7%（1/37）。值得注意的是，在耐药性突变与HBV基因型、性别、年龄、乙肝e抗原状态、基线HBV DNA水平或丙氨酸氨基转移酶、天冬氨酸氨基转移酶、γ-谷氨酰转移酶水平之间未发现显著关联。
本研究强调了未经治疗的患者中存在原发性耐药性突变，并强调了在开始治疗前进行基因分型筛查的重要性。这些发现可能为治疗策略提供参考，并有助于降低治疗失败、肝硬化和肝细胞癌的风险。
