Late failure of combined recombinant hepatitis B vaccine and lamivudine in treatment of a patient with chronic hepatitis B.
We report the first case of a woman having chronic hepatitis B treated with a combination therapy of recombinant hepatitis B vaccine and lamivudine for 18 months. The main aims of such a combined therapy were to assess whether the concomitant anti-hepatitis B virus (HBV) vaccination might prevent the emergence of a mutant HBV and lead to sustained hepatitis B e antigen seroconversion with undetectable serum HBV DNA. The data from the present case demonstrated that combination of anti-HBV vaccine and lamivudine did not eliminate viral DNA despite prolonged treatment and did not have any effect on preventing resistant-type HBV. Although the combined therapy failed to reach the therapeutic endpoints, it concerned a single and unique patient. Hepatitis B vaccine and lamivudine for HBV treatment should be further investigated in randomized controlled trials.
Yalcin
Kendal
K
Division of Hepatology, Department of Internal Medicine, Dicle University School of Medicine, Diyarbaki, Turkey. kendaly@dicle.edu.tr
Degertekin
Halil
H
Bozdayi
Mithat
M
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000008:administration & dosage*; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D013997:Time Factors; D017211:Treatment Failure; D014614:Vaccines, Synthetic / Q000008:administration & dosage
C075656:GenHevac B Pasteur; D017325:Hepatitis B Vaccines; D018894:Reverse Transcriptase Inhibitors; D014614:Vaccines, Synthetic; D019259:Lamivudine