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

Abstract

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 M204I 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.

• Authors: Yun-Jung Oh, Young-Min Park, Sun-Pyo Hong, Soo-Kyeong Shin, Seung-Il Ji, Bo-Hyun Kim, Sang-Jong Park, Zheng Hong
• Journal: Gut and liver (Gut Liver) Vol. 4 Issue 2 Pg. 253-7 (Jun 2010) ISSN: 2005-1212 [Electronic] Korea (South)
• PMID: 20559531 (Publication Type: Journal Article)