Lamivudine for treating active hepatitis B in renal transplant recipients:a case report

Aim: Chronic hepatitis B is still a matter of concern among renal transplan tation patients and patients waiting for a renal transplant since it influe nces negatively morbidity and mortality. Morbidity and mortality are associ ated with HBV replication. Lamivudine is a new antiviral agent whose use ha s been advocated to treat HBV-infected liver transplanted patients. Subject and methods: Here we present our experience with an HBV-positive kidney-li ver transplanted patient treated with lamivudine after transplantation. Res ults: After lamivudine was started HBV-DNA became negative (chemiluminescen ce, Digene Hybrid Capture System, USA 1997) and ALT levels returned to norm al. After eighteen months and after steroid pulses treatment for acute reje ction, HBV-DNA became positive again, probably due to virus mutation. Lamiv udine treatment was not withdrawn since it has been suggested that the muta nt form might be less pathogenic than the wild one. To this extent, more th an 10 months after, our patient is still in a good clinical general conditi on and still takes lamivudine 75 mg/day. No lamivudine-related side effects were recorded. Conclusions: Our case confirms that lamivudine is a safe an d useful tool in treating renal transplant recipients with chronic hepatiti s B.