Discussion: rtM204V/I are primary resistance mutations which mapped in conserved YMDD motif within C domain of the viral RT and facilitate ongoing viral DNA synthesis in the presence of LAM.
Discussion: When treating with LAM, drug resistance arises rapidly and amino acid substitutions compromise rtM204V/I, rtL180M and rtV173L, etc.
Do different lamivudine-resistant hepatitis B genotypes carry the same risk of entecavir resistance?
Abstract: All the patients with rtM204I and rtA181 mutants had undetectable HBV DNA from 18th month.
Abstract: Compared to the patients with the rtM204I mutant, patients with the rtM204V mutant had increased risk of virologic breakthrough (80% vs.
Abstract: Those with the rtM204I and rtA181V mutations may have lower risks, but regular surveillance for viral breakthrough is required.
Low-level persistence of drug resistance mutations in hepatitis B virus-infected subjects with a past history of Lamivudine treatment.
PMID: 23114756
2013
Antimicrobial agents and chemotherapy
Abstract: Sanger sequencing identified >=1 LAM resistance mutations (rtL80I/V, rtM204I, and rtA181T) in samples from 5 (11%) of 46 LAM-experienced and none of 45 LAM-naive subjects (0%; P = 0.06).
Abstract: UDPS detected >=1 LAM resistance mutations (rtL80I/V, rtV173L, rtL180M, rtA181T, and rtM204I/V) in 10 (22%) of the 46 LAM-experienced subjects, including 5 in whom LAM resistance mutations were not identified by S
High frequency of complex mutational patterns in lamivudine resistant hepatitis B virus isolates.
Abstract: Notably, classical antiviral resistance mutations (rtL80I/V-rtI169T-rtV173L-rtL180M-rtA181T/V/S-rtT184A/S/G/C-rtA194T-rtS202C /G/I -rtM204V/I-rtN236T-rtM250V) were n
Efficacy and safety of telbivudine plus adefovir dipivoxil combination therapy and entecavir monotherapy for HBeAg-positive chronic hepatitis B patients with resistance to adefovir dipivoxil.
Abstract: During the 48-week treatment period, two patients in the ETV monotherapy group had viral breakthrough and the strains were confirmed to be of a variant associated with ETV resistance (rtM204V+ rtL180M+ rtT184G), while one patient receiving LdT plus ADV had viral breakthrough and an LdT-associated resistance mutation (rtM204I) was detected.
Efficacy of entecavir switch therapy in chronic hepatitis B patients with incomplete virological response to telbivudine.
Abstract: Although rtM204I and/or rtL180M was detected in 3 of 7 patients with incomplete virological response to entecavir, none of the patients with HBV DNA<2,000 IU/ml during telbivudine treatment harboured these amino acid substitutions.
Detection of rtN236T mutation associated with adefovir dipivoxil resistance in Hepatitis B infected patients with YMDD mutations in Tehran.
PMID: 23467016
2013
Iranian journal of microbiology
Introduction: Long term usage of lamivudine leads to development of drug resistance which is mainly associated with mutations in the YMDD motifs, substitution of methionine by either valine (rtM204I) or isoleucine (rtM204I) in the tyrosine-methionine-aspartate-aspartate (YMDD) motif of the HBV polymerase C d
Result: LAM resistance analysis using RFLP method identified the type of YMDD mutations; 24(80%) patients had the rtM204I mutation, 2 (6.6%) had the rtM204V and 4(13.3%) had both.
Table: M204I
Prophylactic effect of antiretroviral therapy on hepatitis B virus infection.
Result: Amino-acid change rtM180L was found in 87.5% of the cases associated with rtM204I or V but was found as an isolated mutation in 8 remaining cases.
Figure: Cumulative selection of 3TC resistant (rtM204V/I) strains over time in patients who ever received 3TC or FTC.
Discussion: The distribution of 3TC-resistance mutations was very similar to what was previously reported even though rtL180M (29.1%) was found more often than rtM204V/I (26%) .
HBV mutation literature information.
PMID: 
2014
Acta pharmaceutica Sinica. B
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