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Fatal hepatic decompensation in a bone marrow transplant recipient with HBV-related cirrhosis following lamivudine withdrawal
- Source :
- Gastroentérologie Clinique et Biologique. 30:307-309
- Publication Year :
- 2006
- Publisher :
- Elsevier BV, 2006.
-
Abstract
- Lamivudine is a nucleoside analogue with a potent antiviral activity used as prophylaxis against hepatitis B virus reactivation in patients with chronic HBV infection receiving chemotherapy. No standard guidelines exist, however, for the duration of lamivudine treatment. We report a clinical case of a 56-year-old patient with HBeAg-negative cirrhosis who developed a multiple myeloma. He was treated with lamivudine for 1 year while receiving chemotherapy and a subsequent bone marrow transplant. Complete remission from multiple myeloma was achieved. Four months after lamivudine was withdrawn, he experienced HBV reactivation with jaundice, though no YMDD mutations were detected. The patient rapidly developed fatal decompensation with septicemia and renal failure. In conclusion, this case shows that physicians should avoid discontinuing nucleoside therapy in patients with HBV infection who undergo immunosuppression for concomitant neoplastic conditions.
- Subjects :
- Liver Cirrhosis
Male
Hepatitis B virus
medicine.medical_specialty
Cirrhosis
medicine.medical_treatment
medicine.disease_cause
Gastroenterology
Immunocompromised Host
Fatal Outcome
HBV-related cirrhosi
Sepsis
hepatic decompensation
Internal medicine
medicine
Humans
Decompensation
Renal Insufficiency
Multiple myeloma
Bone Marrow Transplantation
Nucleoside analogue
business.industry
Lamivudine
Immunosuppression
bone marrow transplant
General Medicine
Middle Aged
Jaundice
Hepatitis B
medicine.disease
Surgery
Reverse Transcriptase Inhibitors
Virus Activation
medicine.symptom
Multiple Myeloma
lamivudine withdrawal
business
medicine.drug
Subjects
Details
- ISSN :
- 03998320
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Gastroentérologie Clinique et Biologique
- Accession number :
- edsair.doi.dedup.....cf75331fca02048b81317922c7df03c9