Four open reading frames, the S, C, X, and P genes, have been identified within the HBV genome. Because of the overlap of the P and S genes, lamivudine-associated mutations produce changes in the S gene, too. Consequently, lamivudine-resistant HBV isolates show alterations in the ''a'' determinant of the HBsAg protein. Lamivudine-selected HBsAg protein changes may have important virological and clinical implications: They may escape neutralization by vaccine-induced anti-HBs antibodies and thus may have the potential to become vaccine escape mutants. Widespread use of lamivudine may lead to infection of vaccinated individuals and potentially reduce the efficacy of current HBV vaccines.
Was this article helpful?
The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.