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Clinical outcome and virologic profiles of severe hepatitis B exacerbation due to YMDD mutations.

Abstract：

BACKGROUND/AIMS:To study the outcome and the virologic profiles of severe hepatitis exacerbations due to YMDD mutants in lamivudine-treated patients. METHODS:Eighteen lamivudine-treated patients with severe hepatitis exacerbations due to YMDD mutants were recruited. Laboratory and clinical parameters were monitored. Viral genotypes and YMDD mutations were determined. RESULTS:None of the 18 patients had YMDD wild-type during exacerbations. Three (17%) and 15 (83%) patients had genotypes B and C, respectively. Elevated bilirubin levels and prolonged prothrombin time were found in 11 (61%) and six patients (33%) respectively. Three patients (17%) had adverse outcome with the development of ascites and/or encephalopathy. One of these patients required liver transplantation and one died. Both patients had evidence of cirrhosis before treatment and hepatitis B e antigen (HBeAg) seroreversion from anti-HBe positivity. The remaining 16 patients (89%) have no evidence of pre-existing cirrhosis. Thirty seven percent of patients had normal alanine aminotransferase levels at the last follow-up. The median HBV DNA level at the last follow-up was significantly lower than the pre-treatment level (P=0.009). CONCLUSIONS:Though the majority of patients with severe hepatitis exacerbations due to YMDD mutants had uneventful course, early liver transplantation should be considered in patients with pre-existing cirrhosis and HBeAg seroreversion.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Yuen MF,Kato T,Mizokami M,Chan AO,Yuen JC,Yuan HJ,Wong DK,Sum SM,Ng IO,Fan ST,Lai CL

doi

10.1016/s0168-8278(03)00388-x

subject

Has Abstract

pub_date

2003-11-01 00:00:00

pages

850-5

issue

5

eissn

0168-8278

issn

1600-0641

pii

S016882780300388X

journal_volume

39

pub_type

杂志文章

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