Lamivudine

Abstract

S Lamivudine Development of resistance leading to HBV-related membranous nephropathy: case reportA 25-year-old woman developed hepatitis B virus (HBV)related membranous nephropathy due to the development of lamivudine resistance while being treated for HBV infection.The woman, who had Byler's disease and chronic HBV infection, underwent a liver transplant in 1994. Her kidney function had deteriorated due to immunosuppressants and peritonitis. In 2001, she started lamivudine for antiviral therapy [dosage and route not stated]. In 2003, she developed an HBV mutant, with an increase in virus titre and exacerbation of liver dysfunction. Concurrently, she developed haematuria and proteinuria, and her serum creatinine level increased to 2.0 mg/dL. In 2004, she was admitted. Examination revealed anaemia in the palpebral conjunctiva, a palpable liver and spleen, and leg oedema. Tests revealed a blood urea nitrogen level of 39 mg/dL, while hepatitis serology revealed positive HBV DNA, HBs-Ag, HBe-Ag and HBe-Ab. Findings from renal biopsy were consistent with a diagnosis of atypical membranous nephropathy.The woman received adefovir. Subsequently, her HBe antigen level decreased, while her renal function normalised and her urine abnormalities resolved. Adefovir and lamivudine were continued.