Chronic active hepatitis B exacerbations in human immunodeficiency virus-infected patients following development of resistance to or withdrawal of lamivudine.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

Chronic active hepatitis B exacerbations in human immunodeficiency virus-infected patients following development of resistance to or withdrawal of lamivudine.

Clin Infect Dis. 1999 May;28(5):1032-5. Unique Identifier : AIDSLINE MED/99379699
Bessesen M; Ives D; Condreay L; Lawrence S; Sherman KE; Department of Medicine, University of Colorado Health Sciences; Center, Denver, USA. mary.bessesen@med.va.gov

Abstract: Lamivudine is a nucleoside analog with activity against human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Patients coinfected with HIV and HBV may have hepatitis flares when lamivudine therapy is discontinued or when resistance of HBV to lamivudine emerges. This retrospective, descriptive study conducted in three tertiary care medical centers describes patients coinfected with HIV type 1 and HBV who presented with a spectrum of clinical and subclinical hepatitic responses to lamivudine withdrawal or resistance. One patient had fulminant hepatic failure and a second patient had subclinical hepatitis when lamivudine therapy was discontinued and a more efficacious antiretroviral regimen was substituted. Three patients had flares of hepatitis after 13 to 18 months of lamivudine therapy. Lamivudine withdrawal or emergence of lamivudine-resistant mutants in patients coinfected with HIV and HBV may result in severe hepatitis. Clinicians caring for patients with coinfection with HIV and HBV should be aware of the possibility that a hepatitis B flare may occur in previously asymptomatic carrier patients.

Keywords: JOURNAL ARTICLE Adult Anti-HIV Agents/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/BLOOD/*DRUG THERAPY Case Report Drug Resistance Hepatitis B e Antigens Hepatitis B, Chronic/BLOOD/*DRUG THERAPY/ETIOLOGY Human HIV Infections/BLOOD/*DRUG THERAPY *HIV-1 Lamivudine/*THERAPEUTIC USE Male Middle Age Recurrence Retrospective Studies Treatment Failure
991230
A99C1045

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