Decompensated lamivudine-resistant hepatitis B virus-related cirrhosis treated successfully with adefovir dipivoxil allowing surgery for hepatocellular carcinoma.
We describe a 64-year-old man with decompensated hepatitis B virus (HBV)-related cirrhosis who became resistant to lamivudine. He was started on adefovir at 10 mg daily while continuing lamivudine therapy. Several months later, his liver function improved and subsequently his ascites disappeared. The serum HBV-DNA level became undetectable 11 months later. Twenty months after the start of additional treatment with adefovir, one hepatocellular carcinoma (HCC) was detected, and the patient underwent a successful hepatectomy. Our findings suggest that the addition of adefovir to ongoing lamivudine therapy is useful for improving liver function in patients with decompensated lamivudine-resistant HBV-related cirrhosis, allowing surgery for HCC.
Takamura
Masaaki
M
Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Ichida
Takafumi
T
Ohkoshi
Shogo
S
Tsubata
Shunsuke
S
Osaki
Akihiko
A
Aoyagi
Tomoya
T
Nomoto
Minoru
M
Uehara
Kazuhiro
K
Terada
Haruo
H
Aoyagi
Yutaka
Y
D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D018450:Disease Progression; D024882:Drug Resistance, Viral; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
D063065:Organophosphonates; D019259:Lamivudine; C053001:adefovir; D000225:Adenine