Monitoring the emergence of HBV resistance mutations by HBV-RNA pyrosequencing

Letter to the Editor Monitoring the emergence of HBV resistance mutations by HBV-RNA pyrosequencingDear Editor, Hepatitis B virus (HBV) is a unique DNA virus that replicates via pre-genomic RNA. 1 According to current estimates, approximately 4 million individuals living with HIV worldwide have chronic hepatitis B (CHB). 2 For the treatment of HBV/HIV co-infected patients, several guidelines recommend the use of nucleos(t)ide analogues (NA), such as a combined lamivudine (LAM) and tenofovir (TDF) therapy.3 During long-term NA therapy, drug-resistant mutations emerge, resulting in an increase of HBV-DNA expression.During LAM therapy, the most classical mutations are observed in the tyrosine-methionine-aspartate-aspartate (YMDD) motif of the HBV-DNA polymerase at reverse transcriptase domain.3 Low HBV-DNA load in serum may hamper the detection of drug resistance mutations in HBV/HIV co-infected patients.Serum HBV-RNA can be found during LAM therapy and it can be detected when HBV-DNA is undetectable.The objectives of this study were to evaluate HBV-RNA detection in serum of HBV/HIV co-infected patients under antiviral treatment and to detect the early emergence of LAM resistance mutations by pyrosequencing.Ten CHB male patients were enrolled in this study and divided into three groups: I-six HBV/HIV coinfected patients treated with LAM and TDF for one year (M1 and 2429); three and five years (1181 and 3013), and ten years (3107 and 1452); II-two HBV monoinfected naïve patients; and III-two HBV/HIV co-infected naïve patients.Serum samples collected from enrolled patients who provided written informed consent were obtained and stored at -80 • C.This

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