Prevalence of YMDD Variants Leading to Lamivudine Resistance among Chronic HBV Patients in Gaza Strip-Palestine Running title: Lamivudine Resistance in Gaza Strip-Palestine

Abdelraouf A Elmanama, Basim M Ayesh, Eman O Abu Zuhri


Background: Hepatitis B virus (HBV) resistance to lamivudine is reported in several areas worldwide. The prevalence of YMDD variants (YIDD and YVDD) and some risk factors leading to lamivudine resistance were investigated among chronic HBV patients in Gaza strip. Methodology Fifty four patients with viral load above 4500 IU/ml from two governmental hospitals were tested for Lamivudine resistance from October , 2008 to July , 2011. Real Time PCR determination for viral load and Liver function tests were also carried out . Results: The prevalence of YMDD variants was determined and divided into five groups: YMDD (32.6%), YMDD/YIDD in (41.3%), YIDD alone (13%), YIDD/YVDD(2.2%),YMDD/YIDD/YVDD(10.9%).A statistically significant correlation was found between viral load and the preceding five groups (p=0.028). The only significant risk factor for lamivudine resistance was lamivudine intake duration (p=0.049). Conclusion: The prevalence of YMDD variants due to lamivudine resistance among Gaza HBV patients was found to be high, therefore, re-evaluation of management protocols and policies for HBV therapy should be considered. Keywords; Lamivudine resistance, HBV, Gaza


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