Fatal postlymphoma chemotherapy hepatitis B reactivation secondary to the emergence of a YMDD mutant strain with lamivudine resistance in a noncirrhotic patient

Joanna K. Law, Jaber Al Ali, P. Richard Harrigan, Christopher H. Sherlock, Kerry J. Savage, Eric M. Yoshida

Research output: Contribution to journalArticle

Abstract

Hepatitis B reactivation is a well-known complication during or after chemotherapy in chronic hepatitis B (HBV) carriers. The current practice guidelines in Canada and the United States recommends patients receive antiviral prophylaxis prior to the onset of chemotherapy in chronic HBV carriers with lamivudine. We report a case of a 57-year-old man with follicular lymphoma on lamivudine prophylaxis and no clinical evidence of cirrhosis, and developed fatal HBV reactivation after the emergence of a YMDD mutant strain of HBV that confers lamivudine resistance. Fatal reactivation secondary to the development of lamivudine resistance has not, to date, been well- reported. Our experience indicates the need to carefully monitor patients for suspected drug- resistant HBV mutants with the addition of antiviral agents effective against the YMDD mutational strain, when lamivudine resistance emerges.

Original languageEnglish (US)
Pages (from-to)969-972
Number of pages4
JournalAmerican journal of hematology
Volume81
Issue number12
DOIs
StatePublished - Dec 1 2006

Keywords

  • Chemotherapy
  • Hepatitis B
  • Lamivudine
  • Resistance
  • YMDD mutation

ASJC Scopus subject areas

  • Hematology

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