The dynamic changes in HBV DNA levels and resistant variants of the RT domains during ETV treatment of patient 1. (A) The serum HBV DNA level declined gradually and was undetectable after treatment for 3 years and followed-up for 7 years. (B) The dynamic changes in the RT domains of HBV variants, as determined by UDPS. At baseline, this patient displayed rtM204I/V (3.5%), rtL180 M (2.1%), and rtS202G (3.4%) substitutions. A wave of resistant variants (rtM204 V [19.95%], rtL180 M [19.12%], and rtS202G [18.33%]) was detected at 1 year and then decreased to <1% by 2 years. The rtA181T substitution rose from 2.17% to 64.15% by 2 years and certain nonresistance mutations (rtN248A, rtI224 V, and rtS223A) increased significantly. ETV = entecavir, DNA = di-ribonucleic acid, HBV = hepatitis B virus, RT = reverse transcriptase, UDPS = ultra-deep pyrosequencing.