A YIDD Mutation in a Case of Recurrent Hepatitis B after Liver Transplantation Induced by an S-escape Mutant

作者：Oh, Yun-Jung; Park, Young-Min^*; Hong, Sun-Pyo; Shin, Soo-Kyeong; Ji, Seung-Il; Kim, Bo-Hyun; Park, Sang-Jong; Hong, Zheng

来源：Gut and Liver, 2010, 4(2): 253-257.

DOI：10.5009/gnl.2010.4.2.253

• G145R
• G1896A
• Recurrent hepatitis B
• Liver transplantation
• rtM204I

A 47-year-old woman underwent orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related end-stage liver cirrhosis. The patient received hepatitis B immunoglobulin prophylaxis after OLT. Despite the protective level of the serum anti-hepatitis-B surface antibody, HBV recurred at 22 months post-OLT and induced subacute hepatic failure. The pre-OLT HBV genome contained a complex mutation pattern in overlapping frame regions of the surface (S) and polymerase (P) genes, which is the same mutation pattern as seen in post-OLT HBV DNA. G145R and K141R mutations in the "a" determinant were detected only in the post-OLT sample. Clevudine (30 mg once daily) was administered for recurrent hepatitis B. Hepatitis B was reactivated with a flare-up, and a M2041 mutation (YIDD mutant type) appeared with a higher viral load at 9 months after clevudine treatment. We report here a case of a YIDD mutation that developed in recurrent hepatitis B after OLT induced by an S-escape mutant. (Gut Liver 2010;4:253-257)

• 单位
  天津市第一中心医院