Hepatitis B exacerbation with a precore mutant virus following withdrawal of lamivudine in a human immunodeficiency virus-infected patient.
Chronic active hepatitis B exacerbations have been reported following development of resistance to or withdrawal of lamivudine in HIV-infected patients. A 38-year-old woman with HIV and chronic HBV infections was hospitalized because of acute hepatitis. The occurrence of cytolysis with replication of HBV 2 months after withdrawing lamivudine suggests that our patient experienced a severe reactivation of HBV infection due to the modification of her treatment. Sequencing of the HBV precore region showed the strain to be a mutant. We conclude that lamivudine should not be stopped in HIV- and HBV-infected patients, but could be continued at the dose of 100mg/day as used in isolated HBV infection.
Neau
D
D
Fédération des Maladies Infectieuses, Hópital Pellegrin, Bordeaux.
Schvoerer
E
E
Robert
D
D
Dubois
F
F
Dutronc
H
H
Fleury
H J
HJ
Ragnaud
J M
JM
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1 / Q000302:isolation & purification; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000209:etiology* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D009154:Mutation
D019380:Anti-HIV Agents; D019259:Lamivudine