Sustained clinical improvement of a patient with decompensated hepatitis B virus-related cirrhosis after treatment with lamivudine monotherapy.
Hepatitis B virus (HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, remains a major health problem in Asian countries. Recent development of vaccine for prevention is reported to be successful in reducing the size of chronically infected carriers, although the standard medical therapies have not been established up to now. In this report, we encountered a patient with decompensated HBV-related cirrhosis who exhibited the dramatic improvements after antiviral therapy. The patient was a 50-year-old woman. Previous conventional medical treatments were not effective for this patient, thus this patient had been referred to our hospital. However, the administration of lamivudine, a reverse transcriptase inhibitor, for 23 months dramatically improved her liver severity. During this period, no drug resistant mutant HBV emerged, and the serum HBV-DNA level was continuously suppressed. These virological responses were also maintained even after the antiviral therapy was discontinued. Moreover, both hepatitis B surface antigen and e antigen were observed to have disappeared in this patient. The administration of lamivudine to patients with HBV-related cirrhosis, like our present case, should be considered as an initial medical therapeutic option, especially in countries where liver transplantation is not reliably available.
Nagasaki
Futoshi
F
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Ueno
Yoshiyuki
Y
Yamamoto
Takeshi
T
Nakagomi
Yu
Y
Kido
Osamu
O
Kakazu
Eiji
E
Matsuda
Yasunori
Y
Kogure
Takayuki
T
Yamagiwa
Yoko
Y
Kikuchi
Kumiko
K
Fukushima
Koji
K
Kanno
Noriatsu
N
Niitsuma
Hirofumi
H
Shimosegawa
Tooru
T
D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D006515:Hepatitis B virus / Q000187:drug effects / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents; D019259:Lamivudine