A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant.
- Author:
Yun Jung OH
1
;
Young Min PARK
;
Sun Pyo HONG
;
Soo Kyeong SHIN
;
Seung Il JI
;
Bo Hyun KIM
;
Sang Jong PARK
;
Zheng HONG
Author Information
1. Department of Internal Medicine, Bundang Jesang General Hospital, Daejin Medical Center, Seongnam, Korea.
- Publication Type:Case Report
- Keywords:
G145R;
G1896A;
Recurrent hepatitis B;
Liver transplantation;
rtM204I
- MeSH:
Arabinofuranosyluracil;
DNA;
Female;
Genome;
Hepatitis;
Hepatitis B;
Hepatitis B virus;
Humans;
Immunoglobulins;
Liver;
Liver Cirrhosis;
Liver Failure;
Liver Transplantation;
Middle Aged;
Viral Load
- From:Gut and Liver
2010;4(2):253-257
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 47-year-old woman underwent orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related end-stage liver cirrhosis. The patient received hepatitis B immunoglobulin prophylaxis after OLT. Despite the protective level of the serum anti-hepatitis-B surface antibody, HBV recurred at 22 months post-OLT and induced subacute hepatic failure. The pre-OLT HBV genome contained a complex mutation pattern in overlapping frame regions of the surface (S) and polymerase (P) genes, which is the same mutation pattern as seen in post-OLT HBV DNA. G145R and K141R mutations in the "a" determinant were detected only in the post-OLT sample. Clevudine (30 mg once daily) was administered for recurrent hepatitis B. Hepatitis B was reactivated with a flare-up, and a M204I mutation (YIDD mutant type) appeared with a higher viral load at 9 months after clevudine treatment. We report here a case of a YIDD mutation that developed in recurrent hepatitis B after OLT induced by an S-escape mutant.
