Adefovir Dipivoxil for Chemotherapy-Induced Activation of Hepatitis B Virus Infection

Adefovir Dipivoxil for Chemotherapy-Induced Activation of Hepatitis B Virus Infectionto the editor: Adefovir dipivoxil is an oral prodrug of adefovir, an analogue of AMP.Adefovir has recently been used for treatment of chronic infection with hepatitis B virus (HBV), resulting in an improvement in liver histology and a reduction in serum HBV DNA. 1 We describe a case of subfulminant HBV infection that was successfully treated with adefovir.A 69-year-old man with prostate adenocarcinoma (stage D2) and bone metastasis had had intermittent cholestasis of unknown origin years earlier.The patient had completed a course of chemotherapy with mitoxantrone and prednisone 30 days before he was admitted to the hospital for asthenia, anorexia, and jaundice.Laboratory tests revealed an international normalized ratio of 1.61, an alanine aminotransferase level of 990 IU per liter, and a total bilirubin level of 10.7 mg per deciliter