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World J Gastroenterol. Sep 7, 2013; 19(33): 5575-5580
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5575
Published online Sep 7, 2013. doi: 10.3748/wjg.v19.i33.5575
Lactic acidosis during telbivudine treatment for HBV: A case report and literature review
Jia-Lin Jin, Piao Hu, Xiao-Yun Huang, Xin-Hua Weng, Ji-Ming Zhang, Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China
Piao Hu, Department of Infectious Diseases, Xiaoshan First People’s Hospital, Hangzhou 311200, Zhejiang Province, China
Jia-Hong Lu, Su-Shan Luo, Department of Internal Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
Author contributions: Jin JL diagnosed and treated the patient and wrote the manuscript; Hu P followed up the patient; Lu JH and Luo SS performed the muscle biopsy and provided the histopathologic pictures; Huang XY was involved in the preparation of the manuscript; Weng XH and Zhang JM helped diagnose and manage the patients and prepare the manuscript.
Supported by National Natural Science Foundation of China, No. 81071354 and 81271833; National “973’’ Project, No. 2012CB519001; National Science and Technology Major Project of China, No. 2012ZX10002007-001-002, No. 2013ZX10002001
Correspondence to: Ji-Ming Zhang, MD, Department of Infectious Diseases, Huashan Hospital, Fudan University, 12 Wulumuqi Zhonglu, Jing'an District, Shanghai 200040, China. jmzhang@fudan.edu.cn
Telephone: +86-21-52888125 Fax: +86-21-62489015
Received: May 1, 2013
Revised: July 6, 2013
Accepted: July 30, 2013
Published online: September 7, 2013
Processing time: 131 Days and 22.8 Hours
Revised: July 6, 2013
Accepted: July 30, 2013
Published online: September 7, 2013
Processing time: 131 Days and 22.8 Hours
Core Tip
Core tip: Myopathy is the most common side effect resulting from telbivudine. Lactic acidosis (LA) is rare but fatal, and LA caused by telbivudine has never been reported. Here, we report the first case of chronic hepatitis B developing severe refractory LA during telbivudine monotherapy. This case shows that telbivudine may cause muscle damage and even lead to fatal LA in chronic hepatitis B patients. Patients under telbivudine treatment should be closely monitored for muscular, blood lactate and other mitochondrial toxicity associated side effects.