Article Commentary: Antiviral drug Resistance and Hepatitis B: A Continuing Public Health Problem

The use of selective antiviral therapy has been very successful in controlling HBV replication in individuals, leading to a reduction in disease progression and mortality. However, the use of first-generation therapies, often the only available option in low-resource settings, can result in a high prevalence of drug resistance mutations. Variants selected by antiviral therapies targeting the viral polymerase can also result in variants in the viral envelope. These variants can allow the virus to escape the host immune response. The effect of antiviral selection pressure on viral variants that may contribute to immune escape requires further investigation.