Majority of Hep B patients resistant to antiviral therapy

The majority of hepatitis B patients have a genotypic resistance to antiviral therapy, results of the CHARM study show. The large Australian multi-centre study of 483 patients with chronic hepatitis B found that 72% had at least one resistance mutation. There was also an overall genotypic resistance prevalence of 18%. The most frequently reported mutation was M204V/I (14%), followed by L180M (9%), A181V/T (3%), N236T (2%), V173L (2%), T184 (1%) and S202 (<1%). Presented at the Australian Gastrointestinal Week annual conference, the study also found that the majority of patients with mutations had received prior antiviral therapy (83%) and were currently on adefovir (ADV) and lamivudine (LAM) (39%), LAM (16%), ADV plus entecavir (ETV), ETV monotherapy (12%) or ETV 1mg (11%). The patients, who were predominantly male (74%), Asian (76%), and overseas born (94%), tended to be HBeAg positive (60%), with a mean serum alanine aminotransferase (ALT) of 45 U/L. Over 30% had ALT over the upper limit of normal (40 U/L), and 27% had a history of resistance mutations. Lead author Dr Stuart Roberts from the Alfred Hospital in Melbourne and colleagues said that a significant proportion of the resistant study participants also had biochemically active liver disease. “These data highlight the need for early adaption of [antiviral therapy] in patients with a suboptimal response [to treatment],” they said....