Koh Kyung Hyun, Kang Chang Joon, Kim Dong Hoon, Choi Yong Won, Kim Moo Jung, Cheong Jae Youn, Cho Sung Won
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
Korean J Gastroenterol. 2008 Nov;52(5):325-8.
Clevudine is a nucleoside analog of the unnatural beta-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 (>1.0chi10(8) 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.
克来夫定是一种具有非天然β - L构型的核苷类似物，对乙型肝炎病毒（HBV）具有强大的抗病毒活性。预计克来夫定的耐药模式与拉米夫定相似。然而，尚无关于慢性乙型肝炎患者中与克来夫定耐药相关突变的报道。我们报告了一例出现克来夫定耐药的慢性乙型肝炎年轻男性患者。该患者接受了5个月的拉米夫定治疗，血清HBV DNA水平降低。然后，拉米夫定换成克来夫定单药治疗。克来夫定治疗6个月后，患者出现病毒学突破（>1.0×10⁸拷贝/mL）以及生化突破，这与rtM204I加rtL80I突变的存在有关。从克来夫定换用阿德福韦后，病毒载量下降，生化指标改善。
