Severe Exacerbation of  Chronic Hepatitis B after Emergence of Lamivudine Resistance in a Cirrhotic  Patient: Immediate Switch to Adefovir Dipivoxil Appears to be  Indicated

Tischendorf, Jens J. W.; Nashan, Björn; Klempnauer, J.; Flemming, P.; Niemann, Petra S; Rohde, Paul; Manns, Michael P.; Tillmann, Hans L.

doi:10.1055/s-2004-812683

Cited by 19 publications

(14 citation statements)

References 11 publications

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“…3). In particular, the evident decrease of e509-like subpopulation among sustained virological responders is paralleled by a decrease (P ¼ 0.0005) of total titer, already demonstrated in other studies on humoral response against different antigens after successful dual therapy [Wiegand et al, 2004;Toyoda et al, 2005]. The net increase of e509-like subpopulation in the non-responders group is not paralleled by a similar significant increase of total anti-HCV/E2 titre (P ¼ 0.875), thus suggesting that in this group of patients the increase of the amount of antibodies specifically recognizing the e509 epitope is absolute.…”

Section: Persistently Infected Patientssupporting

confidence: 72%

“…Overall, these studies have continued that modifications of the anti-HCV antibody status after therapy, including changes in total anti-HCV/E2 response, are possible. Nonetheless, direct correlation of these changes with the pattern of systemic virus activity, response to treatment, and liver disease progression is still elusive [Wiegand et al, 2004;Toyoda et al, 2005].…”

Section: Introductionmentioning

confidence: 99%

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Modulation of epitope‐specific anti‐hepatitis C virus E2 (anti‐HCV/E2) antibodies by anti‐viral treatment

Mancini¹,

Carletti²,

Perotti³

et al. 2006

Journal of Medical Virology

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The dynamic features of three specific anti-hepatitis C virus (HCV) antibody subpopulations directed against different conformational epitopes of the viral E2 protein (HCV/E2) have been evaluated in patients with primary and persistent HCV infection; the three subpopulations are present in patients infected with different HCV genotypes and have shown a different activity using a pseudovirus neutralization assay (antibodies e301 and e137 exhibiting high neutralizing activity, while antibody e509 enhancement of HCV infectivity). In sequential samples from five patients with primary HCV infection and different virological outcome, all samples tested negative with the single exception of the e509 antibody in a patient not clearing the virus. In sequential samples from 28 patients with persistent infection under treatment with pegylated interferon-alpha plus ribavirin (14 sustained virological responders and 14 non-responders), the therapy did not selectively influence titers of the two neutralizing antibody subpopulations; otherwise, a net increase of the e509 antibody subpopulation related to enhancement of HCV infectivity was observed in non-responders, but not in sustained virological responders (P = 0.0156). This increase was not related to the trend of total anti-HCV/E2 response. The data indicate that a specific antibody response against these epitopes is elicited only late during the infection, thus not influencing virus clearance during primary infection, and that a selective increase of the antibody subpopulation enhancing virus infectivity is observed only in the cohort of patients not responding to antiviral therapy.

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Section: Persistently Infected Patientssupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Modulation of epitope‐specific anti‐hepatitis C virus E2 (anti‐HCV/E2) antibodies by anti‐viral treatment

Mancini¹,

Carletti²,

Perotti³

et al. 2006

Journal of Medical Virology

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“…However, long-term lamivudine treatment caused severe drug-resistance (8). Current evidence does not appear to support adefovir salvage therapy either (18,19). Entecavir was not recommended to patients with severe acute exacerbation of chronic hepatitis B based on the studies by Wong et al (12) which demonstrated a marked elevation of short-term mortality, although the mortality rate had no significant differences between 30 days and 48 weeks (P=0.14).…”

Section: Discussionmentioning

confidence: 98%

Entecavir and lamivudine therapy for severe acute chronic hepatitis B

Liu

Jia

et al. 2012

Experimental and Therapeutic Medicine

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Severe acute exacerbation in patients with chronic hepatitis B is a unique clinical presentation that results in high mortality. To compare the efficacy of 4 weeks of entecavir or lamivudine therapy in patients with severe acute exacerbation caused by chronic hepatitis B, 65 patients were retrospectively analyzed. The groups received 0.5 mg entecavir (group A) or 100 mg lamivudine (group B) daily. After 4 weeks of treatment, virological and biochemical responses and the deterioration rates were determined. The average age and alanine aminotransferase (ALT), bilirubin, albumin, creatinine (Cr), and HBV DNA levels were similar in groups A and B prior to treatment, but the prothrombin time (PT) was shorter in group A. Following treatment, ALT and bilirubin levels were improved while there were no significant changes in PT, albumin or Cr levels at week 4 in group B. Only ALT was markedly upregulated following treatment in group A. There were no significant differences between the virological and biochemical responses or the deterioration rates of the two groups. These results suggested that short-term treatment with lamivudine markedly alleviated the increased bilirubin (TB) levels in patients with severe acute exacerbation of chronic hepatitis B and that there was no significant difference in the deterioration rate between patients treated by the two types of medication.

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“…Interruption of 3TC appears to be relatively safe in a case of emergence of resistant mutants if the alanine aminotransferase values are less than twice the upper limit of normal at the time of stopping lamivudine (17). In patients at risk of decompensated liver disease, an early switch to adefovir dipivoxil could be indicated (18). Interferon alpha proved efficacious to treat an acute liver disease exacerbation occurring after the emergence of a 3TC resistant mutant (19).…”

Section: Discussionmentioning

confidence: 99%

Fatal Interruption of a 3TC-containing Regimen in a HIV-infected Patient Due to Re-activation of Chronic Hepatitis B Virus Infection

Sellier

Clevenbergh

Mazeron

et al. 2004

Scandinavian Journal of Infectious Diseases

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Severe Exacerbation of Chronic Hepatitis B after Emergence of Lamivudine Resistance in a Cirrhotic Patient: Immediate Switch to Adefovir Dipivoxil Appears to be Indicated

Cited by 19 publications

References 11 publications

Modulation of epitope‐specific anti‐hepatitis C virus E2 (anti‐HCV/E2) antibodies by anti‐viral treatment

Modulation of epitope‐specific anti‐hepatitis C virus E2 (anti‐HCV/E2) antibodies by anti‐viral treatment

Entecavir and lamivudine therapy for severe acute chronic hepatitis B

Fatal Interruption of a 3TC-containing Regimen in a HIV-infected Patient Due to Re-activation of Chronic Hepatitis B Virus Infection

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