Short duration of lamivudine for the prevention of hepatitis B virus transmission in pregnancy: lack of potency and selection of resistance mutations.

摘要: This study sought to assess the antiviral efficacy of lamivudine (LMV) administered during third trimester reduce maternal viraemia and identify emergence LMV resistance. A prospective observational analysis was performed on 26 mothers with high viral load (>10⁷ IU/mL). Twenty-one women received (treated group) for an average 53 days (range 22-88 days), remaining five formed untreated control group. Serum samples from two time points were used measure HBV DNA levels drug The LMV-treated achieved a median reduction 2.6-log10 IU/mL. Although end-of-treatment (EOT) in four (18%) remained at >10(7) IU/mL (± 0.5 log IU/mL), no mother-to-baby transmission observed. In contrast, baby mother HBsAg positive 9 months postpartum. Four technologies resistance testing. Only ultra-deep pyrosequencing (UDPS) sufficiently sensitive detect minor variants down <1%. UDPS showed that therapy resulted increased quasispecies diversity selection reverse transcriptase amino acid substitutions sites associated primary (rtM204I/V rtA181T) (19%) women. These detected mostly low frequencies (0.63-5.92%) EOT, but one had rtA181T variant 2.2% pretherapy 25.59% EOT. also infected vaccine escape (sG145R), which inhibited by treatment. late pregnancy only reduced moderately, drug-resistant emerged.