Chronic hepatitis B virus (HBV)
infection leads to long-term sequelae such as
cirrhosis and
hepatocellular carcinoma.
Antiviral therapy aims at controlling the
viral replication and thus, decreasing the likelihood of such
complications. In this study, we evaluated the dynamics of biochemical and virological
parameters over 10 years of
antiviral therapy in a
Thai patient with chronic
HBeAg-negative HBV
infection,
who had relapsed after two
courses of
interferon alfa treatment.
Lamivudine administration initially led to a significant reduction in
alanine aminotransferase (ALT) and HBV
DNA levels, but a subsequent emergence of YIDD mutants caused an ALT flare and a
virus breakthrough. A 4-log HBV
DNA decrease and normalization of the ALT level were achieved within 3 months of adefovir monotherapy without any
relapse during follow-up exceeding 20 months. Thus, careful
monitoring during
treatment and
knowledge of cross-resistance to
antiviral salvage therapy are crucial for the management of
patients with
chronic hepatitis B.