Joh Riho, Hasegawa Kiyoshi, Tokushige Katsutoshi, Hashimoto Etsuko, Torii Nobuyuki, Yamashiro Takeshi, Enomoto Nobuyuki, Watanabe Mamoru, Hayashi Naoaki
Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo.
Intern Med. 2003 Jul;42(7):581-6. doi: 10.2169/internalmedicine.42.581.
In 1997, a 27-year-old homosexual man contracted acute hepatitis B that developed into chronic hepatitis. Because of repeated flares, administration of lamivudine was started in March 2002. Hepatitis B virus (HBV) DNA immediately decreased, but the serum level of alanine aminotransferase gradually increased. Drug-induced hepatitis due to lamivudine was excluded. It was suspected that the progression of liver damage was caused by hepatitis delta virus (HDV), because the patient was positive for both anti-HDV antibody and HDV RNA. Co-infection of HDV should be considered a possibility if liver injury is not improved by lamivudine therapy.
1997年，一名27岁的同性恋男子感染急性乙型肝炎并发展为慢性肝炎。由于病情反复发作，2002年3月开始使用拉米夫定治疗。乙型肝炎病毒（HBV）DNA立即下降，但丙氨酸转氨酶的血清水平逐渐升高。排除了拉米夫定引起的药物性肝炎。怀疑肝损伤的进展是由丁型肝炎病毒（HDV）引起的，因为该患者抗HDV抗体和HDV RNA均为阳性。如果拉米夫定治疗不能改善肝损伤，则应考虑HDV合并感染的可能性。
