Open Access

Entecavir resistance in a patient with treatment‑naïve HBV: A case report

  • Authors:
    • Andrea Marino
    • Federica Cosentino
    • Manuela Ceccarelli
    • Vittoria Moscatt
    • Alessio Pampaloni
    • Daniele Scuderi
    • Flavia D'andrea
    • Emmanuele Venanzi Rullo
    • Giuseppe Nunnari
    • Francesco Benanti
    • Benedetto Maurizio Celesia
    • Bruno Cacopardo
  • View Affiliations

  • Published online on: April 6, 2021     https://doi.org/10.3892/mco.2021.2275
  • Article Number: 113
  • Copyright: © Marino et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Among nucleos(t)ide analogue therapies for hepatitis B virus (HBV) treatment, entecavir (ETV) and tenofovir disoproxil fumarate (TDF)/tenofovir alafenamide are associated with the lowest rate of drug resistance. ETV is a drug requiring at least three substitutions in the reverse transcriptase (RT) domain to develop resistance, which is a rare occasion in treatment‑naïve patients. However, pre‑existing or acquired single mutations in the RT domain could lead to a virological breakthrough, after viral suppression. The present case report describes a 58‑year‑old female patient with hepatitis B virus (HBV) and high viral load who started HBV treatment with ETV. After 85 weeks of treatment, HBV‑DNA declined to 0 IU/ml and remained undetectable for 3 years. However, after that period of time, the HBV‑DNA rebounded, followed by the rise of liver enzymes (aspartate aminotransferase and alanine transaminase). Only the substitution M204I was detected in the HBV polymerase region. The patient was then switched to TDF treatment, achieving normalization of the liver enzymes and a decline in HBV‑DNA levels. The present case report suggests that nucleoside‑naïve patients should be cautiously monitored for resistance, even more than biochemically (transaminases, bilirubin) and virologically (HBV‑DNA), even if complete HBV suppression is achieved.
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June-2021
Volume 14 Issue 6

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Spandidos Publications style
Marino A, Cosentino F, Ceccarelli M, Moscatt V, Pampaloni A, Scuderi D, D'andrea F, Rullo EV, Nunnari G, Benanti F, Benanti F, et al: Entecavir resistance in a patient with treatment‑naïve HBV: A case report. Mol Clin Oncol 14: 113, 2021
APA
Marino, A., Cosentino, F., Ceccarelli, M., Moscatt, V., Pampaloni, A., Scuderi, D. ... Cacopardo, B. (2021). Entecavir resistance in a patient with treatment‑naïve HBV: A case report. Molecular and Clinical Oncology, 14, 113. https://doi.org/10.3892/mco.2021.2275
MLA
Marino, A., Cosentino, F., Ceccarelli, M., Moscatt, V., Pampaloni, A., Scuderi, D., D'andrea, F., Rullo, E. V., Nunnari, G., Benanti, F., Celesia, B. M., Cacopardo, B."Entecavir resistance in a patient with treatment‑naïve HBV: A case report". Molecular and Clinical Oncology 14.6 (2021): 113.
Chicago
Marino, A., Cosentino, F., Ceccarelli, M., Moscatt, V., Pampaloni, A., Scuderi, D., D'andrea, F., Rullo, E. V., Nunnari, G., Benanti, F., Celesia, B. M., Cacopardo, B."Entecavir resistance in a patient with treatment‑naïve HBV: A case report". Molecular and Clinical Oncology 14, no. 6 (2021): 113. https://doi.org/10.3892/mco.2021.2275