Adefovir dipivoxil 開始後2年2カ月で breakthrough hepatitis を認めた lamivudine 耐性B型肝硬変の1例

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We report a case of both lamivudine (LAM) and adefovir dipivoxil (ADV) resistant liver cirrhosis type B. A 47-year-old woman was hospitalized with chronic active hepatitis with cirrhosis type B. Because her serum alanine aminotransferase (ALT) and hepatitis B virus (HBV) DNA level elevated, she was treated with LAM (100 mg/day). Serum ALT and HBV DNA reductions were observed in 4 months. Nine months after the administration of LAM, HBV DNA and ALT levels re-elevated following the appearance of YMDD mutant (YVDD+YIDD). Additional treatment with ADV (10 mg/day) was commenced, and her serum ALT was decreased during 3 months. However, breakthrough phenomena were observed again 26 months after ADV treatment. This is the first reported case of breakthrough hepatitis associated with both LAM-and ADV-resistant HBV.
社団法人　日本肝臓学会の論文
2005-12-25