Reactivation of lamivudine-resistant occult hepatitis B in an HIV-infected patient undergoing cytotoxic chemotherapy
| Autor: | Marie-José Sanson-Le Pors, Jean-Marc Zini, Nathalie Schnepf, Marie-Christine Mazeron, Pierre Sellier, Marc Bendenoun |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Hepatitis B virus HBsAg medicine.medical_specialty HIV Infections medicine.disease_cause Gastroenterology Virology Internal medicine Antineoplastic Combined Chemotherapy Protocols Drug Resistance Viral medicine Adefovir Humans Hepatitis business.industry Lymphoma Non-Hodgkin HIV virus diseases Lamivudine Hepatitis B medicine.disease digestive system diseases Non-Hodgkin's lymphoma Infectious Diseases HBeAg Virus Activation business medicine.drug |
| Zdroj: | Journal of Clinical Virology. 39:48-50 |
| ISSN: | 1386-6532 |
| Popis: | Background Reactivation of occult hepatitis B virus (HBV) infection is a well-known complication of cytotoxic chemotherapy. Lamivudine prophylaxis is recommended to reduce the incidence and severity of hepatitis in this context. Case report An HIV-infected patient positive for HBs antigen became positive for HBc antibody alone under lamivudine given as part of antiretroviral therapy. He was treated with chemotherapy for non-Hodgkin's lymphoma while under lamivudine. Then, he developed HBV-related hepatitis that led to delay chemotherapy. He received adefovir that induced a dramatic decline in HBV DNA load and a normalisation of hepatic enzyme levels. However, the patient died of a relapse of lymphoma. Retrospective analysis of stored plasma samples showed evidence of lamivudine-resistant occult hepatitis before the onset of chemotherapy and reactivation of the HBV mutant. Conclusion To our knowledge, this is the first report of occult hepatitis reactivation due to lamivudine-resistant mutant selected under lamivudine therapy in an HIV-infected patient. Our study underlines the need to carefully investigate lamivudine resistance in HIV-infected patients with occult infection under lamivudine therapy. Those patients should be monitored with the addition of anti-viral agents effective against the mutant strain. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect