Unsuccessful rescue therapy with adefovir dipivoxil for lamivudine resistant HBV in a patient with liver failure

Adefovir dipivoxil is a new nucleoside analogue which is active against lamivudine resistant hepatitis B virus (HBV). A 48 week course of adefovir in human immunodeficiency virus type 1 infected patients with lamivudine resistant HBV induces a rapid and major decrease in serum HBV DNA levels with improvement in liver inflammation.1 Although reassuring, this efficacy of adefovir may be influenced by the timing of its initiation after the emergence of lamivudine resistant HBV. We report here the case of a cirrhotic patient treated with lamivudine for four years who died of liver failure due to the emergence of lamivudine resistant HBV, despite the introduction of …