Journal Article

Chronic Active Hepatitis B Exacerbations in Human Immunodeficiency Virus-Infected Patients Following Development of Resistance to or Withdrawal of Lamivudine

Mary Bessesen, David Ives, Lynn Condreay, Steven Lawrence and Kenneth E. Sherman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 5, pages 1032-1035
Published in print May 1999 | ISSN: 1058-4838
Published online May 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514750
Chronic Active Hepatitis B Exacerbations in Human Immunodeficiency Virus-Infected Patients Following Development of Resistance to or Withdrawal of Lamivudine

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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 lamivudineresistant 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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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