A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant

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.

Relationship Between Variation and Distribution of Differential Gene Sites of Hepatitis B Virus and Enzymatic Activity of Liver Function / 中华医院感染学杂志

0.05).CONCLUSIONS G1896A Variation principally distributes in HBeAg(-) group that expressed low level HBV DNA.A1762T Variation and HBeAg(+) haven′t obvious correlation.YMDD variation principally distributes in HBeAg(+) group that expressed high lever HBV DNA.YMDD variation initiates acute damage of liver cell.The variation of G1896A or A1762T may contribute to progressive damage of chronic liver disease.