Korean J Hepatol.  2008 Dec;14(4):513-518. 10.3350/kjhep.2008.14.4.513.

A case report of treatment with pegylated interferon alpha for lamivudine-resistant chronic hepatitis B virus infection

• Hur WH
• Woo HY
• Jeong SW
• You CR
• Bae SH
• Choi JY
• Yoon SK

• KMID: 1073303
• DOI: http://doi.org/10.3350/kjhep.2008.14.4.513

Abstract

The wide use of lamivudine in chronic hepatitis B has produced a monotonic increase in patients with lamivudine resistance. Therefore, treating lamivudine resistance in chronic hepatitis B is a major concern in clinical practice for the treatment of hepatitis B virus (HBV). There is conflicting evidence on the outcome of pegylated interferon alpha (PEG-IFN alpha) therapy against lamivudine-resistant HBV, which is due to mutations in the YMDD motif. We experienced a patient with chronic hepatitis B who was successfully treated with PEG-IFN alpha-2a after the development of virologic and biochemical breakthrough during lamivudine therapy. Virologic breakthrough was associated with the emergence of YMDD mutants 48 months after starting lamivudine therapy. Treatment with PEG-IFN alpha-2a for 12 months resulted in an undetectable serum level of HBV DNA and the resolution of hepatitis, and the virologic response was maintained over 16 months after cessation of PEG-IFN alpha-2a.

Keyword

Pegylated interferon alfa-2a; Lamivudine; YMDD motif mutant; Hepatitis B, Chronic

MeSH Terms

Adult
Alanine Transaminase/blood
Antiviral Agents/*therapeutic use
DNA, Viral/analysis
Drug Resistance, Viral
Hepatitis B, Chronic/diagnosis/*drug therapy
Humans
Interferon Alfa-2a/*therapeutic use
Lamivudine/*therapeutic use
Liver/pathology
Male
Polyethylene Glycols/*therapeutic use