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JAC Advance Access published online on January 24, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn014
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Leading article

Hepatitis B virus escape mutants induced by antiviral therapy

Julie Sheldon and Vincent Soriano*

Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain

* Corresponding author. Tel: +34-91-4532650; Fax: +34-91-7336614; E-mail: vsoriano{at}dragonet.es

The hepatitis B virus (HBV) polymerase and envelope genes overlap in such a way that resistance mutations to antiviral agents in the reverse transcriptase gene may affect the antigenicity of the HBV surface antigen. Mutant viruses may escape serological diagnosis using specific anti-HBV surface antigen antibodies, causing occult forms of chronic hepatitis B. Moreover, these HBV strains may evade vaccine protection, representing a public health challenge. Thus, the circulation of HBVs encoding envelope mutations selected by antiviral agents requires close monitoring.

Key Words: hepatitis B virus , HBV , drug resistance , lamivudine , HBsAg , occult hepatitis , vaccine


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