Severe hepatitis and prolonged hepatitis B virus-specific CD8 T-cell response after selection of hepatitis B virus YMDD variant in an HIV/hepatitis B virus-co-infected patient.
We describe here a severe flare of hepatitis caused by lamivudine-resistant hepatitis B virus(HBV) in an HIV/HBV co-infected individual.Lamivudine-resistant HBV was detected 6 months before the development of severe hepatitis. Sequencing of the HBV genome isolated from the patients' serum did not identify compensatory mutations in the HBV polymerase that may have restored viral replication. However, a strong HBV-specific CD8 T-cell response was identified and may have resulted in the severe hepatitis.
Department of Medicine (RMH), University of Melbourne, Melbourne, Australia.
Theo
T
Gouskos
Fiona
F
Wightman
Judy
J
Chang
Linda
L
Earnest-Silveira
Joseph
J
Sasadeusz
Sharon R
SR
Lewin
Joseph
J
Torresi
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001483:Base Sequence; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D004279:DNA, Viral / Q000032:analysis; D024882:Drug Resistance, Viral; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000150:complications / Q000235:genetics / Q000276:immunology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D014779:Virus Replication / Q000235:genetics / Q000276:immunology
D004279:DNA, Viral; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine