The emergence of HBV drug-resistant (and multidrug-resistant) strains during long-term therapy with nucleo-side/nucleotide analogues is associated with treatment failure and therefore presents a clinical challenge. For clinicians, close monitoring and management of resistance have become important to clinical practice. For HBV virologists, the understanding of the mechanism of emergence of specific mutant strains in the viral quasispecies during treatment is also critical. If a particular viral strain can emerge in the quasispecies within a particular environment, it is probably because its fitness is superior to other strains. The present review focuses on viral fitness as well as viral infectivity, and in particular on technical means that are available to study viral fitness in vitro and in animal models.
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