Drug Resistance Mutations in the Polymerase Gene of HBV in Three Generations of Patients with Chronic Hepatitis B

Hepatitis B virus polymerase proofreading defects lead to frequent DNA mutations in the hepatitis B virus genome and contribute to treatment resistance. This study aimed to examine drug-resistant mutations in three generations of patients with chronic hepatitis B. Based on the inclusion criteria, 90 chronic HBV patients in northeastern Iran were divided into three groups. HBV DNA, liver function tests, serological markers, and liver stiffness measurements were also evaluated. Polymerase gene sequencing was used to identify mutations linked to resistance to NAs. P-values less than 0.05 indicated statistical significance. All samples were genotyped as genotype D/subtype ayw2. HBeAg was detected positive in 12.3% of samples, with viral loads (P-value=0.02) and LFT (P-value=0.007) significantly higher than in HBeAg-negative samples. YMDD, YINN, and FLMAQ mutations were found in 26.7%, 4.5%, and 5.5% of CHB patients, respectively. YIDD and FLIPH mutations occur together in 3.4% of three-generation patients and 10% of two-generation patients. The three-generation group showed a higher mean LSM (4.2±1.6 KPa) than the other groups. Detection of mutations is essential for physicians to decide on antiviral medication choices and management. These results suggest that polymerase resistance mutations in three and two generations of patients should be examined before starting antiviral treatment.