Lamivudine Therapy Improves Survival In Hepatitis B Surface Antigen...

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Lamivudine Therapy Improves Survival In Hepatitis B Surface Antigen-Positive Kidney Transplant Patients
A DGReview of :"reemptive lamivudine therapy based on HBV DNA level in HBsAg-positive kidney allograft recipients."
Hepatology

10/31/2002
By James Adams


Pre-emptive lamivudine therapy based on serum hepatitis B virus (HBV) DNA levels and clinical monitoring improves survival in patients undergoing kidney transplant.

Investigators from the University of Hong Kong in Hong Kong studied the effect of lamivudine treatment in hepatitis B surface antigen-positive renal allograft patients who underwent transplantation.

Eleven new patients who underwent kidney transplantation between 1996 and fifteen existing patients who underwent kidney transplantation between 1983 and 1995 were included in the study.

Serial serum HBV DNA measurements were performed and patients with increasing HBV DNA levels were given Pre-emptive lamivudine regardless of aminotransferase levels.

Patients reached the criteria for administration of lamivudine at 8.4 ± 6.2 months after transplantation.

All treated patients experienced suppression of HBV DNA and normalization of aminotransferase levels.

Hepatitis B e antigen seroconversion was achieved in 21.4 per cent of the patients.

Survival rate of the new (1996-2000) patients treated with Pre-emptive lamivudine was similar to that of hepatitis B surface antigen-negative controls.

The hepatitis B surface antigen-positive patients who underwent transplantation between 1983 and 1995 showed poorer survival with a relative risk of death of 9.7 and relative risk of liver-related mortality of 68.0 compared with the other patients.

Discontinuation of lamivudine was attempted in 12 low-risk patients after successful stabilization. Treatment was safely discontinued in five of these patients (41.7 per cent).

Pre-emptive lamivudine improves survival in selected hepatitis B surface antigen-positive renal allograft patients, the investigators conclude.
Hepatology 2002; 36(5): 1246-1252. "reemptive lamivudine therapy based on HBV DNA level in HBsAg-positive kidney allograft recipients."