Precore mutant HBV-infection in a cirrhotic patient experiencing lamivudine-resistance and adefovir-nonresponse: no histological and immuno-histochemical evidence of re-infection…

Aims: Antiviral-drug-resistance is a common phenomenon in chronic hepatitis B therapy. Lamivudine-resistant mutants are mostly sensitive to the nucleoside analogue adefovir dipivoxil. Adefovir-resistant mutants are rare and retain sensitive to lamivudine. Patients with cirrhosis and precore mutant infection have an increased risk for exacerbation of liver disease due to drug-resistance. Viral resistance against both drugs is an indication for switching treatment to experimental antiviral regimes. Main therapeutic need is to prevent virological failure as well as to reach sufficient viral suppression before liver…