{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:57:05Z","timestamp":1790225825961,"version":"4.1.0"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[2001,12,4]]},"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Nucleoside analogues such as lamivudine for chronic hepatitis B have an excellent safety profile while patients are on therapy but reactivation flares occur in 19\u201350% of patients after stopping therapy, some of whom develop liver decompensation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Aims:<\/jats:bold>\n                    To describe and report three cases who developed fatal hepatitis B reactivation after stopping nucleoside analogue therapy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects and results:<\/jats:bold>\n                    Three patients are described who developed hepatitis B reactivation and liver decompensation after stopping therapy. One of the three patients was participating in a famciclovir trial and the other two were receiving lamivudine therapy for active hepatitis B infection. All three patients had documented hepatitis B flares, and all had hepatitis B virus DNA detected at that time. All patients developed decompensated liver disease despite one patient having had a prior liver biopsy showing absence of cirrhosis. Reintroduction of lamivudine therapy failed to halt progression of liver decompensation even after hepatitis B virus DNA had been demonstrated to be absent. Sequencing for lamivudine resistant mutants in two cases where serum was available failed to show evidence of mutations associated with lamivudine resistance.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Hepatitis B virus reactivation, leading to decompensation and death, are possible complications of treatment withdrawal and patients should be monitored closely if therapy is ceased.\n                  <\/jats:p>","DOI":"10.1136\/gut.51.4.597","type":"journal-article","created":{"date-parts":[[2002,9,16]],"date-time":"2002-09-16T15:02:56Z","timestamp":1032188576000},"page":"597-599","source":"Crossref","is-referenced-by-count":100,"title":["Fatal hepatitis B reactivation following discontinuation of nucleoside analogues for chronic hepatitis B"],"prefix":"10.1136","volume":"51","author":[{"given":"S G","family":"Lim","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore (119074)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C T","family":"Wai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore (119074)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Rajnakova","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore (119074)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Kajiji","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore (119074)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Guan","sequence":"additional","affiliation":[{"name":"Mount Elizabeth Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,10,1]]},"reference":[{"key":"2025121313225590000_51.4.597.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199807093390201"},{"key":"2025121313225590000_51.4.597.2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510290321"},{"key":"2025121313225590000_51.4.597.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80013-0"},{"key":"2025121313225590000_51.4.597.4","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199958010-00015"},{"key":"2025121313225590000_51.4.597.5","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1997.v113.pm9322520"},{"key":"2025121313225590000_51.4.597.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512213332501"},{"key":"2025121313225590000_51.4.597.7","first-page":"697","volume":"128","year":"1998","journal-title":"Ann Intern Med"},{"key":"2025121313225590000_51.4.597.8","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2000.16333"},{"key":"2025121313225590000_51.4.597.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91829-9"},{"key":"2025121313225590000_51.4.597.10","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300427"},{"key":"2025121313225590000_51.4.597.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-0934(96)02093-9"},{"key":"2025121313225590000_51.4.597.12","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1600-0676.1990.tb00455.x","volume":"10","year":"1990","journal-title":"Liver"},{"key":"2025121313225590000_51.4.597.13","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250144"},{"key":"2025121313225590000_51.4.597.14","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1155\/2000\/142782","volume":"14","year":"2000","journal-title":"Can J Gastroenterol"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.51.4.597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T21:23:03Z","timestamp":1765660983000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.51.4.597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,10]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2002,10,1]]},"published-print":{"date-parts":[[2002,10]]}},"alternative-id":["10.1136\/gut.51.4.597"],"URL":"https:\/\/doi.org\/10.1136\/gut.51.4.597","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,10]]}}}