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Antimicrobial Drug Resistance pp 565–577Cite as

The Hepatitis B Virus and Antiviral Drug Resistance: Causes, Patterns and Mechanisms

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Abstract

The hepatitis B virus (HBV) is a DNA-containing virus that belongs to the family Hepadnaviridae. Selection of HBV quasispecies with mutations in the viral reverse transcriptase (rt) during antiviral therapy can result in progression of liver disease and, in some cases, significant clinical deterioration. The development of antiviral drug resistance depends on a number of parameters such as the magnitude and rate of viral replication, the fidelity of the viral polymerase, the selective pressure of the drug, the amount of replication space in the liver and the fitness of the resistant virus. Thus, in the treatment of chronic hepatitis B, the development of drug resistance is not unexpected if viral replication continues in the setting of ongoing therapy. Prevention of resistance requires the adoption of strategies that effectively control virus replication, and in its simplest form this is using antiviral drugs that are potent and have a high genetic barrier, namely entecavir or tenofovir. This chapter briefly reviews the major aspects of the molecular virology and replication of HBV and summarises the viral mutants of clinical significance that are associated with drug resistance. Also, the factors and mechanisms of drug resistance in hepatitis B are discussed. Finally, strategies to prevent the emergence of drug resistance are addressed.

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Authors and Affiliations

  1. Research and Molecular Development, Victorian Infectious Diseases Reference Laboratory, Doherty Institute, Level 2, 792 Elizabeth Street, Melbourne, VIC, 3000, Australia

    Stephen A. Locarnini MBBS, BSc, (Hon), PhD, FRCPath.

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  1. Stephen A. Locarnini MBBS, BSc, (Hon), PhD, FRCPath.
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Correspondence to Stephen A. Locarnini MBBS, BSc, (Hon), PhD, FRCPath. .

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Editors and Affiliations

  1. Treiber Therapeutics, Cambridge, Massachusetts, USA

    Douglas L. Mayers

  2. Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA

    Jack D. Sobel

  3. Centre de recherche en Infectiologie, University of Laval, Quebec City, Canada

    Marc Ouellette

  4. Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA

    Keith S. Kaye

  5. Infection Control and Prevention Unit of Infectious Diseases, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Dror Marchaim

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Locarnini, S.A. (2017). The Hepatitis B Virus and Antiviral Drug Resistance: Causes, Patterns and Mechanisms. In: Mayers, D., Sobel, J., Ouellette, M., Kaye, K., Marchaim, D. (eds) Antimicrobial Drug Resistance. Springer, Cham. https://doi.org/10.1007/978-3-319-46718-4_38

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