Development of tenofovir disoproxil fumarate resistance after complete viral suppression in a patient with treatment-naïve chronic hepatitis B: A case report and review of the literature

Figure 1 Full sequencing analysis of the hepatitis B virus reverse transcriptase gene from the patient (Korean sample). The sequence analysis shows that mutations occurred at 9 sites compared to the wild-type genotype C (the patient was infected with genotype C). The rt106 and rt118 sites are expressed as “?” because the sites contained a substitution by 2 different nucleotides.

Figure 2 Chromatogram of the hepatitis B virus reverse transcriptase gene from the patient. The rt101 (red arrow) and rt118 (arrow) sites are shown as a double line because the site contained a substitution by 2 different nucleotides (cytosine and guanine).

Figure 3 Clinical course of the patient. Hepatitis B virus DNA became undetectable after 16 mo of antiviral treatment with TDF. Virologic and biochemical breakthroughs occurred at 43 mo after treatment initiation.