Gut Liver.
2010 Jun;4(2):253-257.
A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant
- Affiliations
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- 1Department of Internal Medicine, Bundang Jesang General Hospital, Daejin Medical Center, Seongnam, Korea.
- 2Division of Hepatology, Department of Internal Medicine, Bundang Jesang General Hospital, Daejin Medical Center, Seongnam, Korea. ympark@dmc.or.kr
- 3GeneMatrix, Yongin, Korea.
- 4Surgery of Transplantation, Tianjin First Central Hospital, Tianjin, China.
Abstract
- A 47-year-old woman underwent orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related end-stage liver cirrhosis. The patient received hepatitis B immunoglobulin prophylaxis after OLT. Despite the protective level of the serum anti-hepatitis-B surface antibody, HBV recurred at 22 months post-OLT and induced subacute hepatic failure. The pre-OLT HBV genome contained a complex mutation pattern in overlapping frame regions of the surface (S) and polymerase (P) genes, which is the same mutation pattern as seen in post-OLT HBV DNA. G145R and K141R mutations in the "a" determinant were detected only in the post-OLT sample. Clevudine (30 mg once daily) was administered for recurrent hepatitis B. Hepatitis B was reactivated with a flare-up, and a M204I mutation (YIDD mutant type) appeared with a higher viral load at 9 months after clevudine treatment. We report here a case of a YIDD mutation that developed in recurrent hepatitis B after OLT induced by an S-escape mutant.
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