Selection of a multiple drug-resistant hepatitis B virus strain in a liver-transplanted patient.

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Submitted on 27 Feb 2007

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Selection of a multiple drug-resistant hepatitis B virus

strain in a liver-transplanted patient.

Stéphanie Villet, Christian Pichoud, Jean-Pierre Villeneuve, Christian Trépo,

Fabien Zoulim

To cite this version:

Stéphanie Villet, Christian Pichoud, Jean-Pierre Villeneuve, Christian Trépo, Fabien Zoulim. Selection of a multiple drug-resistant hepatitis B virus strain in a liver-transplanted patient.. Gastroenterology, WB Saunders, 2006, 131 (4), pp.1253-61. �10.1053/j.gastro.2006.08.013�. �inserm-00133169�

Genotype E ADV HBIg TENO LAM 1 2 3 4 5 6 7 9 to 16 Serum samples: ₈ HBsAg: _{+ + + + + - - + +} 1,00E+02 1,00E+03 1,00E+04 1,00E+05 1,00E+06 1,00E+07 1,00E+08 0 20 40 60 80 100 120 months of treatment HBV DNA (IU/ml) Liver transplantation

0 10 20 30 40 50 60 70 80 90 100 0 10 20 30 40 50 60 70 80 90 100 C107stop P120S percentage of the mutations months of treatment Liver transplantation 1 2 3 4 5 6 7 8 to 13 Serum samples

lamivudine

treatment

(

months

)

0 10 20 30 40 50 60 70 80 90 100 0 24

% of variants in the viral quasi-species

Viral rebound

wt (S:66) wt (S:14) L180M+M204V (S:0) M204I (S:50) L180M+A181V (S:12) L180M+T184I+M204V (S:25) 1 18 L180M+A200V+M204V (S:25) L180M+A200V+M204V (S:0) 12 M204V (S:0)

0 10 20 30 40 50 60 70 80 90 100 1 L180M+M204I (S:100) wt (S:14) V173L+L180M+A181V+M204V (S:100) M204I (S:100) V173L+L180M+A181V (S:83) V173L+L180M+A181V+M204V+N236T (S:100) V173L+L180M+A181V+N236T (S:100) V173L+L180M+A181V+N236T (S:100) V173L+L180M+A181V+N236T (S:100) V173L+L180M+A181V+M204V+N236T (S:100) V173L+L180M+A181V+M204V (S:100) V173L+L180M+A181V+M204V (S:100) V173L+L180M+A181V+M204V (S:100) V173L+L180M+A181V+M204V (S:100) L180M+M204I (S:100) N236T (S:0) V173L+L180M+A181V+M204I (S:100) I169V+L180M+T184I+M204V (S:0)

Lamivudine

+

adefovir

treatment

(

months

)

1 8 24 34 38 40 42 to 50

Viral rebound

0 16 26 30 32 34 to 42

Time post-transplantation (

months

)

V173L+L180M+A181V+N236T (S:100)

1 wt V173L+L180M+A181V V173L+L180M+A181V+M204VV173L+L180M+A181V+N236T V173L+L180M+A181V+M204V+N236T

A

B

0 20 40 60 80 100 120 140 11 wt L180M+M204V L180M+T184I+M204V

_{L180M+A200V+M204V}

M204I

L180M+A181V 0 20 40 60 80 100 120 1