Mutations in the hepatitis B virus polymerase gene associated with antiviral treatment for hepatitis B

J Viral Hepat. 1999 May;6(3):183-94. doi: 10.1046/j.1365-2893.1999.00160.x.


Significant advances have been made, during the last 5 years, in the treatment of chronic hepatitis B. Several new antiviral agents: lamivudine, famciclovir, lobucavir and adefovir, have been shown to be safe and effective in inhibiting hepatitis B virus (HBV) replication. These compounds can be administered orally and are well tolerated. However, virus clearance is uncommon after short courses (<6 months) of therapy. Lamivudine and famciclovir have been evaluated in Phase III clinical trials in patients with chronic hepatitis B as well as in liver transplant recipients. Unfortunately, drug-resistant mutants involving the HBV polymerase gene, leading to breakthrough infection, have been reported in some patients who have received long courses (>/= 12 months) of treatment. The incidence, clinical outcome and biological significance of these mutants will be reviewed.

Publication types

  • Review

MeSH terms

  • Amino Acid Sequence
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • DNA-Directed DNA Polymerase / chemistry
  • DNA-Directed DNA Polymerase / genetics*
  • Drug Resistance, Microbial
  • Hepatitis B / drug therapy*
  • Hepatitis B / virology
  • Hepatitis B virus / drug effects
  • Hepatitis B virus / enzymology*
  • Hepatitis B virus / genetics
  • Humans
  • Molecular Sequence Data
  • Mutation
  • RNA-Directed DNA Polymerase / chemistry
  • RNA-Directed DNA Polymerase / genetics*
  • Ribonuclease H / genetics


  • Antiviral Agents
  • RNA-Directed DNA Polymerase
  • DNA-Directed DNA Polymerase
  • Ribonuclease H