From:  Hepatitis B virus induced cirrhosis and hepatocarcinoma: pathogenesis and therapeutics

Drug resistance mutations in HBV polymerase gene and rescue anti-HBV therapies after developing drug resistance

Type of drug resistanceDrug resistance mutations in HBV polymerase gene [61]Recommended treatment [47]
LAM resistancert80V/I, rtl169T, rtV173L, rtL180M, rtA181T, rtT184S, rtM204V/I, rt236TChange to TDF or TAF
Telbivudine resistancertM204IChange to TDF or TAF
Adeforvir resistancert181T/V, rt236TWithout LAM/telbivudine resistance: change to ETV, TDF or TAF;
With LAM/telbivudine resistance: change to TDF or TAF
Tenofovir resistancertA194TNo resistance detected to date
ETV resistancertl169T, T184A/C/F/G/I/L/M/S, rtM204V/I, rt202G/C/I, M250I/L/VETV + TDF or ETV + TAF;
Change to TDF or TAF
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ETV: entecavir; LAM: lamivudine; TAF: tenofovir alafenamide; TDF: tenofovir disoproxil fumarate