Hepatitis B virus (HBV) mutations associated with resistance to lamivudinein patients coinfected with HBV and human immunodeficiency virus

Mutations associated with hepatitis B virus (HBV) resistance to lamivudine have not been extensively addressed in human immunodeficiency virus (HIV)-H BV coinfection. We have studied the HBV polymerase sequences from nine coin fected patients who experienced HBV recurrence while under lamivudine treat ment. In seven of these nine patients, Met(550), belonging to the highly co nserved YMDD motif, was mutated to Val and was associated with a substituti on of Met for Leu(526) in each case. In the two remaining patients, we foun d a Met(550)-to-Ile change that was associated in only one case with a Leu( 526)-to-Met mutation. No mutation was observed in three control patients no t receiving lamivudine. This study demonstrates the emergence of particular genetic profiles in HBV-HIV-coinfected patients experiencing a loss of con trol of HBV infection despite high doses of lamivudine.