LAMIVUDINE TREATMENT OF ADVANCED AND DECOMPENSATED LIVER-DISEASE DUE TO HEPATITIS-B

The purpose of this study was to evaluate the effectiveness and safety of lamivudine treatment in patients with advanced and end-stage liver disease caused by hepatitis B. Nine cases of advanced or end-stage li ver disease due to hepatitis B infection, were treated with lamivudine . Four received liver transplants while receiving lamivudine. Moreover , each of these four has been maintained on lamivudine therapy post-tr ansplantation while receiving immunosuppression., No cases of HBV reac tivation. have been seen. More importantly, the allograft liver tissue has been HBc and HBs antigen negative as well as HBV-DNA negative by PCR. This report suggests that 1) lamivudine can be given safely to li ver transplant candidates; 2) lamivudine suppresses HBV replication, s o much so that HBV-DNA becomes undetectable in the serum; 3) despite p owerful immunosuppression. associated with transplantation, HBV reacti vation does not occur under lamivudine therapy; and 4) the observation s should cause transplant physicians, surgeons and third-party payers to reconsider their positions relative to transplantation of individua ls with HBV-associated cirrhosis.