ArticleTherapeutic advances in infectious disease
A systematic review and meta-analysis of hepatitis B virus drug resistance and escape mutations in low- and middle-income countries.
Article in Therapeutic advances in infectious disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Hepatitis B virus (HBV) remains highly endemic in many low- and middle-income countries (LMICs), where challenges such as antiviral resistance and immune/vaccine-escape mutations complicate disease management. Objective: This review synthesizes current data on HBV drug resistance, including the prevalence and distribution of resistance-associated mutations (RAMs), vaccine-escape mutations (VEMs), and immune-escape mutations (IEMs) in LMICs. Design: Systematic review and meta-analysis. Data sources: PubMed, Scopus, and Web of Science. Methods: A systematic search was conducted from 2014 to 2025 (last search date: August 04, 2025), and data were extracted from eligible studies. A random-effects meta-analysis was conducted to estimate pooled resistance rates and prevalences. Results: A total of 43,834 participants from 47 studies conducted in 28 LMICs were included. The overall antiviral resistance rate was 7.87% (95% CI (5.13-11.11)), with very high heterogeneity ( Conclusion: The remarkably high drug resistance rates and prevalence of immune and vaccine-escape mutations suggest notable burdens of resistance, especially for drugs with low genetic barriers such as lamivudine and telbivudine, underscoring the growing challenges in achieving the WHO 2030 reduction goals, and highlighting the need for enhanced surveillance, adoption of potent antiviral regimens such as tenofovir disoproxil fumarate, and continuous vaccine efficacy monitoring. However, the results should be interpreted with caution due to the very high heterogeneity observed in the study. Trial registration: International prospective register of systematic reviews (PROSPERO) under the ID: CRD420251030302.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.