Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2018; 24(17): 1919-1924
Published online May 7, 2018. doi: 10.3748/wjg.v24.i17.1919
Development of tenofovir disoproxil fumarate resistance after complete viral suppression in a patient with treatment-naïve chronic hepatitis B: A case report and review of the literature
Woo Hee Cho, Hyun Jae Lee, Ki Bae Bang, Seok Bae Kim, Il Han Song
Woo Hee Cho, Hyun Jae Lee, Ki Bae Bang, Seok Bae Kim, Il Han Song, Department of Internal Medicine, Dankook University College of Medicine, Cheonan 31116, South Korea
Author contributions: Cho WH, Lee HJ and Bang KB collected the patient’s clinical data; Cho WH, Kim SB and Song IH designed the report and wrote the paper.
Informed consent statement: The patient was not required to give informed consent for this study because this study used clinical data that were obtained after this patient agreed to treatment but before treatment initiation.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seok Bae Kim, MD, Professor, Department of Internal Medicine, Dankook University College of Medicine, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, South Korea. 11961019@dankook.ac.kr
Telephone: +82-41-5503910 Fax: +82-41-5563256
Received: March 21, 2018
Peer-review started: March 21, 2018
First decision: March 30, 2018
Revised: April 1, 2018
Accepted: April 15, 2018
Article in press: April 15, 2018
Published online: May 7, 2018
ARTICLE HIGHLIGHTS
Case characteristics

The patient had not complained of any specific symptoms.

Clinical diagnosis

The hepatitis B virus DNA titer rebounded to 7.5 log10 copies/mL at 43 mo after TDF treatment in a treatment-naive patient.

Differential diagnosis

We performed full genome sequencing to find other mutation sites to know it is associated with tenofovir disoproxil fumarate (TDF) resistance.

Laboratory diagnosis

We performed full genome sequencing to find TDF mutation sites and the results showed mutations at 9 sites, namely, rtY9H, rtL91I, rtS106C, rtS106G, rtT118C, rtT118G, rtQ267L, rtI269L, rtA317S, rtK333Q, and rtN337H.

Treatment

We changed the therapy from tenofovir to entecavir with a regimen of 0.5 mg once daily.

Experiences and lessons

We have to consider possibility of TDF resistance although its rarity.