Method: K141E/I/R and
G145A/R have the strongest evidence base of clinical and in vitro data to support HBV vaccine resistance, while other VEMs are considered putative, as they are supported by less robust data.
Method: We performed phylogenetic dating to estimate the times of emergence of mutations of interest, focused on RAMs
V173L,
L180M and
M204I/V as they are best recognized to cause or contribute (individually or synergistically) resistance to 3TC, ETV and TDF, and VEMs
G145A/R and
K141E/I/R as they have been best described to cause HBV vaccine resistance.