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“Ideally, long‐term lamivudine therapy should not induce tyrosine– methionine–aspartate–aspartate (YMDD) mutants (reverse transcription [rt]; rt M204I/V) in patients with chronic hepatitis B. There is little or no information on the clinical features of patients who do not develop such mutants.”
“However, the emergence of the tyrosine , methionine, aspartate, aspartate (YMDD) mutation in the virus during lamivudine therapy blunts the improvements (17).”
“A major concern with lamivudine therapy is the frequent occurrence of drug-resistant mutations (in the tyrosine , methionine, aspartate, aspartate [YMDD] locus of the HBV DNA polymerase).”