Development of Clevudine Resistance after Switching from Lamivudine in a Patient with Chronic Hepatitis B.
- Author:
Kyung Hyun KOH
1
;
Chang Joon KANG
;
Dong Hoon KIM
;
Yong Won CHOI
;
Moo Jung KIM
;
Jae Youn CHEONG
;
Sung Won CHO
Author Information
1. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea. sung_woncho@hotmail.com
- Publication Type:Case Report ; English Abstract
- Keywords:
Chronic hepatitis B;
Clevudine;
Resistance
- MeSH:
Adenine/analogs & derivatives/therapeutic use;
Adult;
Amino Acid Substitution;
Antiviral Agents/*therapeutic use;
Arabinofuranosyluracil/*analogs & derivatives/therapeutic use;
Base Sequence;
DNA, Viral/blood;
Drug Resistance, Multiple, Viral;
Hepatitis B e Antigens/metabolism;
Hepatitis B, Chronic/*drug therapy/genetics;
Humans;
Lamivudine/*therapeutic use;
Male;
Phosphonic Acids/therapeutic use;
Reverse Transcriptase Inhibitors/*therapeutic use
- From:The Korean Journal of Gastroenterology
2008;52(5):325-328
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Clevudine is a nucleoside analog of the unnatural beta-L configuration which has potent antiviral activity against hepatitis B virus (HBV). Clevudine is expected to have similar pattern of resistance profile as lamivudine. However, there was no report on the mutation associated with clevudine resistance in patients with chronic hepatitis B. We report a case of young male patient with chronic hepatitis B who presented with clevudine resistance. The patient had received lamivudine therapy for 5 months with reduced serum HBV DNA levels. Then, lamivudine was switched to clevudine monotherapy. After the 6 months of clevudine therapy, the patient developed virologic breakthrough (>1.0x10(8) copies/mL) as well as biochemical breakthrough, which was associated with the presence of rtM204I plus rtL80I mutant. After switching from clevudine to adefovir, the viral load decreased with biochemical improvement.
