Lamivudine resistance and exacerbation of hepatitis B in infliximab-treated Crohn's disease patient

✍ Scribed by Maria Esteve; Carme Loras; Ferran González-Huix

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 71 KB
• Volume: 13
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20202

✦ Synopsis

2004 we reported 3 cases of chronic hepatitis B in Crohn's disease (CD) patients from a cohort of 80 patients treated with infliximab. 1 Two patients showed severe reactivation, 1 of whom died. Based on the American Association for the Study of Liver Disease (AASLD) and European guidelines, 2,3 preemptive lamividune was administered to the third patient, and no flare-up of hepatitis B virus (HBV) infection was detected 6 months after first infliximab infusion, when the article was accepted for publication. Lamivudine resistance can be detected in 14% to 32% after 1 year and 60% to 70% after 5 years of treatment. Thus, we suggested in a previous article 1 that adefovir dipivoxil could be a better option for patients requiring long-term immunosuppressive therapy because resistance occurs at a slower rate compared to with lamivudine. 4 However, the patient was maintained on lamivudine because of a good sustained response and based on widely accepted recommendations at that time.

We report here long-term follow-up of this patient, who showed se-