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Article: Clinical outcome and virologic profiles of severe hepatitis B exacerbation due to YMDD mutations

TitleClinical outcome and virologic profiles of severe hepatitis B exacerbation due to YMDD mutations
Authors
KeywordsHepatitic decompensation
Mortality
Severe hepatitis B exacerbation
YMDD mutation
Issue Date2003
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
Journal Of Hepatology, 2003, v. 39 n. 5, p. 850-855 How to Cite?
AbstractBackground/Aims: To study the outcome and the virologic profiles of severe hepatitis exacerbations due to YMDD mutants in lamivudine-treated patients. Methods: Eighteen lamivudine-treated patients with severe hepatitis exacerbations due to YMDD mutants were recruited. Laboratory and clinical parameters were monitored. Viral genotypes and YMDD mutations were determined. Results: None of the 18 patients had YMDD wild-type during exacerbations. Three (17%) and 15 (83%) patients had genotypes B and C, respectively. Elevated bilirubin levels and prolonged prothrombin time were found in 11 (61%) and six patients (33%) respectively. Three patients (17%) had adverse outcome with the development of ascites and/or encephalopathy. One of these patients required liver transplantation and one died. Both patients had evidence of cirrhosis before treatment and hepatitis B e antigen (HBeAg) seroreversion from anti-HBe positivity. The remaining 16 patients (89%) have no evidence of pre-existing cirrhosis. Thirty seven percent of patients had normal alanine aminotransferase levels at the last follow-up. The median HBV DNA level at the last follow-up was significantly lower than the pre-treatment level (P = 0.009). Conclusions: Though the majority of patients with severe hepatitis exacerbations due to YMDD mutants had uneventful course, early liver transplantation should be considered in patients with pre-existing cirrhosis and HBeAg seroreversion. © 2003 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/77168
ISSN
2015 Impact Factor: 10.59
2015 SCImago Journal Rankings: 4.570
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorKato, Ten_HK
dc.contributor.authorMizokami, Men_HK
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorYuan, HJen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorSum, SMen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLai, CLen_HK
dc.date.accessioned2010-09-06T07:29:01Z-
dc.date.available2010-09-06T07:29:01Z-
dc.date.issued2003en_HK
dc.identifier.citationJournal Of Hepatology, 2003, v. 39 n. 5, p. 850-855en_HK
dc.identifier.issn0168-8278en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77168-
dc.description.abstractBackground/Aims: To study the outcome and the virologic profiles of severe hepatitis exacerbations due to YMDD mutants in lamivudine-treated patients. Methods: Eighteen lamivudine-treated patients with severe hepatitis exacerbations due to YMDD mutants were recruited. Laboratory and clinical parameters were monitored. Viral genotypes and YMDD mutations were determined. Results: None of the 18 patients had YMDD wild-type during exacerbations. Three (17%) and 15 (83%) patients had genotypes B and C, respectively. Elevated bilirubin levels and prolonged prothrombin time were found in 11 (61%) and six patients (33%) respectively. Three patients (17%) had adverse outcome with the development of ascites and/or encephalopathy. One of these patients required liver transplantation and one died. Both patients had evidence of cirrhosis before treatment and hepatitis B e antigen (HBeAg) seroreversion from anti-HBe positivity. The remaining 16 patients (89%) have no evidence of pre-existing cirrhosis. Thirty seven percent of patients had normal alanine aminotransferase levels at the last follow-up. The median HBV DNA level at the last follow-up was significantly lower than the pre-treatment level (P = 0.009). Conclusions: Though the majority of patients with severe hepatitis exacerbations due to YMDD mutants had uneventful course, early liver transplantation should be considered in patients with pre-existing cirrhosis and HBeAg seroreversion. © 2003 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhepen_HK
dc.relation.ispartofJournal of Hepatologyen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectHepatitic decompensationen_HK
dc.subjectMortalityen_HK
dc.subjectSevere hepatitis B exacerbationen_HK
dc.subjectYMDD mutationen_HK
dc.subject.meshHepatitis B - drug therapy - genetics - physiopathology - virology-
dc.subject.meshHepatitis B virus - genetics-
dc.subject.meshLamivudine - therapeutic use-
dc.subject.meshMutation-
dc.subject.meshReverse Transcriptase Inhibitors - therapeutic use-
dc.titleClinical outcome and virologic profiles of severe hepatitis B exacerbation due to YMDD mutationsen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0168-8278&volume=39&issue=5&spage=850&epage=855&date=2003&atitle=Clinical+outcome+and+virologic+profiles+of+severe+hepatitis+B+exacerbation+due+to+YMDD+mutationsen_HK
dc.identifier.emailYuen, MF: mfyuen@hkucc.hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1016/S0168-8278(03)00388-Xen_HK
dc.identifier.pmid14568270-
dc.identifier.scopuseid_2-s2.0-10744226572en_HK
dc.identifier.hkuros86101en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10744226572&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume39en_HK
dc.identifier.issue5en_HK
dc.identifier.spage850en_HK
dc.identifier.epage855en_HK
dc.identifier.isiWOS:000186441500025-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK
dc.identifier.scopusauthoridKato, T=7405277868en_HK
dc.identifier.scopusauthoridMizokami, M=7103318255en_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridYuen, JCH=7102620480en_HK
dc.identifier.scopusauthoridYuan, HJ=7402446707en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridSum, SM=6603889132en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK

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