Hepatitis B Resistance and Quantitative HDV RNA Testing

More than 300 million people worldwide are chronically infected with the hepatitis B virus (HBV). Chronic hepatitis B is a major public health concern and a complex issue for patient care. Treatment options have significantly expanded over the last decade. Besides pegylated interferon-alpha, six nucleoside or nucleotide analogs (NA) with activity against HBV are currently available. Prolonged NA treatment is required in many cases to maintain viral suppression, with an inherent risk of the development of antiviral resistance. Correct treatment indication, an optimal choice of first-line therapy, careful monitoring during NA treatment and preemptive add-on of a second drug with a complementary resistance profile in case of incomplete virologic response are crucial to avoid antiviral resistance. Should antiviral resistance arise despite these measures, adequate management is essential. In this case, treatment choices are facilitated by the knowledge of the specific HBV reverse transcriptase (rt) mutation pattern in a given patient.
Chronic hepatitis D is resurging in Northern Europe, including Switzerland, in the context of immigration of patients from countries where this form of hepatitis is common. Current treatment consists of pegylated interferon-alpha for at least one year. The quantitative assessment of hepatitis D virus (HDV) viremia is not only important to confirm the diagnosis of hepatitis D but also, and even more importantly, to monitor treatment responses.

HBV antiviral resistance and HDV quantitative RNA testing in our laboratory have been established as a collaboration with the Division of Gastroenterology and Hepatology of the Centre Hospitalier Universitaire Vaudois, University of Lausanne. These efforts, and currently offered services to the Swiss community, have been made possible through unrestricted educational grants from Novartis, Roche, Gilead and Essex.

To know more on the HBV life cycle and clinical aspects of chronic HBV infection go to Background and to know more on diagnostic aspects of both viruses go to Diagnostics.

To submit samples to our laboratory for HBV resistance or HDV RNA testing, please use the CHUV-IMU order form No 151(provided upon request to 021-3144107) and accompany it with the clinical form ( 27 Ko). When submitting a sample to us, you are responsible to unequivocally identify the sample with its matching clinical form by using the labels provided with the CHUV-IMU order form and patient name, first name, date of birth as well as physician coordinates.

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