Genetic Variability and Drug Resistance of Hepatitis B Virus in Treatment-Naïve Chronic Hepatitis B Patients

Despite the availability of an effective vaccine and antiviral therapies designed to suppress viral replication by targeting the catalytic region of the RT gene, HBV infection remains a significant public health challenge worldwide. This study aimed to examine the variability of the HBV whole genome in HBsAg-positive individuals who had never received specific antiviral treatments with NAs. The goal was to investigate the prevalence of viral quasispecies among these patients, focusing on those exhibiting: (1) amino acid mutations associated with resistance to antiviral drugs, (2) the ability to evade immune responses, and/or (3) characteristics that promote progression to severe liver disease or hepatocellular carcinoma (HCC).