Development of Clevudine Resistance after Switching from Lamivudine in a Patient with Chronic Hepatitis B
라미부딘 치료 후 클레부딘으로 전환한 만성 B형간염 환자에서 발생된 클레부딘 내성 1예: 연관 염기서열 분석
고, 경현; 강, 창준; 김, 동훈; 최, 용원; 김, 무정; 정, 재연; 조, 성원
The Korean journal of gastroenterology, 52(5):325-328, 2008
The Korean journal of gastroenterology; Taehan Sohwagi Hakhoe chi
Clevudine is a nucleoside analog of the unnatural β-L configuration which has potent antiviral activity against hepatitis B virus (HBV). Clevudine is expected to have similar pattern of resistance profile as lamivudine. However, there was no report on the mutation associated with clevudine resistance in patients with chronic hepatitis B. We report a case of young male patient with chronic hepatitis B who presented with clevudine resistance. The patient had received lamivudine therapy for 5 months with reduced serum HBV DNA levels. Then, lamivudine was switched to clevudine monotherapy. After the 6 months of clevudine therapy, the patient developed virologic breakthrough (＞1.0×108 copies/mL) as well as biochemical breakthrough, which was associated with the presence of rtM204I plus rtL80I mutant. After switching from clevudine to adefovir, the viral load decreased with biochemical improvement.
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