D. Neau et al., Hepatitis B exacerbation with a precore mutant virus following withdrawal of lamivudine in a human immunodeficiency virus-infected patient, J INFECTION, 41(2), 2000, pp. 192-194
Chronic active hepatitis B exacerbations have been reported following devel
opment of resistance to or withdrawal of lamivudine in HIV-infected patient
s. A 38-year-old woman with HIV and chronic HBV infections was hospitalized
because of acute hepatitis. The occurrence of cytolysis with replication o
f HBV 2 months after withdrawing lamivudine suggests that our patient exper
ienced a severe reactivation of HBV infection due to the modification of he
r treatment. Sequencing of the HBV precore region showed the strain to be a
mutant. We conclude that lamivudine should not be stopped in HIV- and HBV-
infected patients, but could be continued at the dose of 100 mg/day as used
in isolated HBV infection. (C) 2000 The British Infection Society.