J. Kletzmayr et al., Twelve months of lamivudine treatment for chronic hepatitis B virus infection in renal transplant recipients, TRANSPLANT, 70(9), 2000, pp. 1404-1407
Background Chronic hepatitis B virus (HBV) infection increases morbidity an
d mortality in renal transplant recipients (RTR), Lamivudine has shown prom
ising results in patients with chronic hepatitis B, but experience with its
use in RTR is limited.
Methods. In a prospective, open labeled, uncontrolled trial, 19 HBsAg(+) RT
R were treated with lamivudine for 12 months. HBV-serologic analysis, HBV-D
NA quantitation, and HBV genome sequence analysis were performed every 3 mo
nths.
Results. At baseline 16 patients were HBV DNA(+), 12 patients were HBeAg(+)
/Ab (-). After 3 months HBV DNA was negative in 80% of patients. In the 3 p
atients with elevated liver enzymes, normal values were achieved within 12
weeks. At 12 months 4 of 8 HBeAg(+)Ab(-) patients on treatment showed HBeAb
, two of them with loss of HBeAg. Three patients developed mutations of the
HBV polymerase gene associated with lamivudine resistance.
Conclusions. Lamivudine is safe and effective in HBsAg(+) RTR, the rate of
HBe-seroconversion and of lamivudine-resistance is comparable to that of no
nimmunosuppressed patients.