FIG. 7.

(a) Course of a clinical case. HBV DNA was measured by a transcription-mediated amplification assay (logarithmic genome equivalent [LGE] per milliliter). L, M, I, and V of rt180 or rt204 represent the amino acids leucine, methionine, isoleucine, and valine, respectively. (b) Changes in viral amounts of the LLAQ and YMDD motifs. ALT levels were stable while the LLAQ/YIDD strain was dominant. When the LMAQ/YVDD strain became dominant over preexisting strains, breakthrough hepatitis occurred.