Hepatic Failure Caused by Reactivation of YMDD Mutants  Occurring during Preemptive Lamivudine Therapy

Chan Ran You; 장정원; Jae Ki Choi; 배시현; 윤승규; 계철승; 최종영

추천

검색

자료유형: 학술저널

저자정보: Chan Ran You 장정원 Jae Ki Choi 배시현 윤승규 계철승 최종영

저널정보: 거트앤리버 발행위원회 Gut and Liver Gut and Liver 제4권 제2호

발행연도: 2010.1

수록면: 262 - 265 (4page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Reactivation of hepatitis B virus (HBV) replication is a frequent phenomenon in patients receiving immunosuppressants or chemotherapy. It was recently reported that regional therapy, such as transarterial chemotherapy (TAC) or radiotherapy, can also induce HBV reactivation in patients with hepatocellular carcinoma (HCC), and this can be prevented by preemptive lamivudine treatment. We report an unusual case of fatal hepatitis caused by reactivation of the tyrosine-methionine-aspartate-aspartate (YMDD) lamivudine-resistant strain in a 51-year-old male patient with HCC who was receiving preemptive lamivudine therapy. This patient received combined helical tomotherapy and TAC for the treatment of HCC with pulmonary metastasis. HBV reactivation and hepatitis exacerbation occurred after 2 months of therapy, but preemptive antiviral therapy was continued. Laboratory tests showed that the serum HBV DNA level had increased by more than 10,000-fold and a severe elevation of the aminotransferase level to 1,060 U/L. Although adefovir was added to lamivudine immediately after detecting the YMDD mutants, the patient eventually died of hepatic failure. Our experience suggests that for preemptive therapy, the use of potent antiviral drugs with a low risk of drug resistance as well as close viral monitoring are important for chronic HBV carriers undergoing intensive anticancer therapy.

#Hepatocellular carcinoma #Viral reactivation #Hepatic failure #Radiotherapy #Transarterial chemotherapy

참고문헌 (18)

참고문헌 신청

Atkins M / 1998 / Lamivudine resistance in chronic hepatitis B / J Hepatol 28 : 169 ~

Chou CH / 2007 / Radiation-induced hepatitis B virus reactivation in liver mediated by the bystander effect from irradiated endothelial cells / Clin Cancer Res 13 : 851 ~ 85

Hong TS / 2007 / Megavoltage computed tomography: an emerging tool for image-guided radiotherapy / Am J Clin Oncol 30 : 617 ~ 623

Honkoop P / 1997 / Lamivudine resistance in immunocompetent chronic hepatitis B. Incidence and patterns / J Hepatol 26 : 1393 ~ 1395

Jang JW / 2004 / Transarterial chemo-lipiodolization can reactivate hepatitis B virus replication in patients with hepatocellular carcinoma / J Hepatol 41 : 427 ~ 435

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!