ZİA UR RAHMAN, MAJİD MAHMOOD
Viral Hepatitis Journal - 2025;31(1):1-7
Drug resistance is a significant hurdle in the control and treatment of chronic hepatitis B virus (HBV) infection. This resistance is caused by some mutations in the viral genome which enable alternative ways for viral replication; which otherwise is blocked by nucleot(s)ide analogues (NAs). To overcome this hurdle, the correct drug selection is required because a specific mutation may bestow upon the virus resistance against a particular drug, but it remains susceptible to others. Significant literature has been published on the topic since the start of NAs use as a treatment option for chronic HBV patients. This review summarizes all the literature published on resistant mutations in the reverse transcriptase domain of the HBV genome, most of which have been reported. After a detailed screening, 36 studies were included in the final review. It is concluded that the most frequent mutations related to resistance are rtM204V/S/I/Y, rtM180C/L/I/T, rtN236T, rtA181T/V/S and rtV173L. Mutations rtT184S, rtN238D/S/R, rtA194T, rtL80V/G/I, rtS202I/G/C, rtV214A/T/I, rtV207L/M, rtI169T/P, and rtM250V/I/L are less common but are also reported to be associated with viral resistance.
