Hepatitis B virus drug resistance tools: one sequence, two predictions

Intervirology. 2014;57(3-4):232-6. doi: 10.1159/000361076. Epub 2014 Jul 15.


Drug resistance testing, genotype analysis, and the determination of immune and vaccine escape variants support personalized antiviral treatment for hepatitis B patients. As phenotypic drug resistance testing for hepatitis B virus (HBV) is especially labor-intensive, due to the lack of simple cell culture systems, genotypic methods play a very pronounced role. The genetic structure of HBV allows the simultaneous analysis of two different genes by examination of a single region in the genome of HBV. Nevertheless, the overlapping open reading frames of the hepatitis B surface antigen (HBsAg) and the reverse transcriptase (RT) have to be interpreted separately. In diagnostic procedures, standard Sanger type sequencing (mostly performed as a dye-dideoxynucleotide terminator system) is still the most commonly used method. This allows using established techniques for interpreting those types of genetic information. Besides reviewing the foundation of drug resistance interpretation for HBV, different interpretation systems, either commercially available (TRUGENE, Abbott, ViroScore) or free to use (geno2pheno[HBV], HIV-GRADE HBV tool), are compared in this article.

Publication types

  • Comparative Study

MeSH terms

  • Adenine / analogs & derivatives
  • Adenine / pharmacology
  • Antiviral Agents / pharmacology
  • Base Sequence
  • Drug Resistance, Multiple, Viral / genetics*
  • Genotype
  • Guanine / analogs & derivatives
  • Guanine / pharmacology
  • Hepatitis B Surface Antigens / genetics
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B virus / classification
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / genetics*
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Immune Evasion / genetics
  • Immune Evasion / immunology
  • Lamivudine / pharmacology
  • Microbial Sensitivity Tests
  • Organophosphonates / pharmacology
  • RNA-Directed DNA Polymerase / genetics
  • Reverse Transcriptase Inhibitors / pharmacology*
  • Sequence Analysis, DNA
  • Telbivudine
  • Tenofovir
  • Thymidine / analogs & derivatives
  • Thymidine / pharmacology


  • Antiviral Agents
  • Hepatitis B Surface Antigens
  • Organophosphonates
  • Reverse Transcriptase Inhibitors
  • Telbivudine
  • Lamivudine
  • entecavir
  • Guanine
  • adefovir
  • Tenofovir
  • RNA-Directed DNA Polymerase
  • Adenine
  • Thymidine