Efficacy and safety of lamivudine in renal transplant patients with chronic hepatitis B

Antoine, Corinne; Landau, Alain; Menoyo, V.; Duong, Jean-Paul; Duboust, A; Glotz, Denis

doi:10.1016/s0041-1345(99)00987-2

Cited by 18 publications

(5 citation statements)

References 6 publications

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“…Liver biopsy findings were not available in eight studies. [1217–1921222728] In studies where biopsy findings were available, cirrhosis was seen in nearly one-third patients, while in our study, none of the patients had cirrhosis on histology. Patients on maintenance hemodialysis are tested for HBsAg on monthly basis as a policy in all the units.…”

Section: Discussioncontrasting

confidence: 53%

“…HBeAg positivity was variable ranging from 17–100% patients while in our study it was 77%. In five studies[14172527–28] liver enzyme status at the time of starting lamivudine was not available, while in the remaining studies, ALT was elevated in most of the patients. Liver biopsy findings were not available in eight studies.…”

Section: Discussionmentioning

confidence: 99%

“…Enzyme normalization status was not available in six studies,[141718212225] while in rest of studies it was seen in 53–100% patients. Hepatocytes damage in the course of chronic hepatitis B is mainly immune mediated, in addition to a less significant role of direct HBV hepatotoxicity.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and tolerability of lamivudine in hepatitis B infected renal transplant recipients: A single center study

Agarwal¹,

Sc²

2009

Indian J Nephrol

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Hepatitis B virus (HBV) infection in patients on hemodialysis and renal transplantation (RT) usually has an unfavorable course. Lamivudine is a synthetic nucleoside analog with a potent action on HBV replication. There is limited data on lamivudine in renal transplant patients with HBV infection and no published report from India. Present study reports on lamivudine therapy in these patients. Patients with HBV infection taken for RT were included. Hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg), HBV-DNA, and liver biopsy before RT were done in all patients. Lamivudine was given in the dose of 50 mg daily during the dialysis and 100 mg daily following successful transplant. Response was evaluated at one year. Of the 739 adult RTs during study period, 35 (4.7%) had HBV infection. Mean age of patients was 30.7 ± 9.8 (16–55 years) and 88.5% were males. Four (11.4%) patients had HCV coinfection. HCV was not treated in any patient. All patients were HBsAg and HBV-DNA positive, while 27 (77%) were HBeAg positive. Mean ALT was 77.8 ± 90 IU/dl; 11 (31.4%) patients had normal ALT. Mean liver biopsy grade was 5.2 ± 1.5 (3–9) and stage was 0.7 ± 0.6 (0–2). At one year following transplantation, ALT was normal in 27 (77%) cases, HBV-DNA undetectable in 16 (45.7%), HBeAg and HBsAg seroconversion in 8 (22.8%), and 3 (8.6%) cases, respectively. All patients tolerated the drug without any significant side effects. Treatment with lamivudine in dialysis and renal transplant patients is well tolerated and safe with efficacy comparable to patients with normal renal function.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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Efficacy and tolerability of lamivudine in hepatitis B infected renal transplant recipients: A single center study

Agarwal¹,

Sc²

2009

Indian J Nephrol

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“…Several uncontrolled, small-sized studies have described the efficacy and safety profile of lamivudine use in RT recipients with HBV infection [41][42][43][44][45][46][47][48][49][50][51]. In a meta-analysis which included 14 clinical studies (n=184 patients), the mean overall estimate for HBV DNA and HBeAg clearance was 91% (95% CI, 86-96%) and 27% (95% CI, 16-39%), respectively [52].…”

Section: Therapy Of Hepatitis B After Rt: Lamivudinementioning

confidence: 99%

Management of Chronic Hepatitis B in Special Populations: Immunosuppressed Patients and Chronic Kidney Disease

2011

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Hepatitis B virus (HBV) infection remains an important cause of liver disease in the population with chronic kidney disease, including patients on long-term dialysis and renal transplant (RT) recipients. Diminished survival due to hepatitis B has been observed after RT. A thorough evaluation, including liver biopsy as well as assessment of serum markers of HBV replication (ie, hepatitis B e antigen and/or HBV DNA) is required before transplantation. Tolerance to interferon is poor both in dialysis patients and after renal transplant. Oral antiviral therapy now permits safe and potent antiviral treatment of HBV-related liver disease in chronic kidney disease patients with prevention of progressive liver disease. Preliminary evidence shows an improved survival of HBsAg positive renal allograft recipients on antiviral therapy. However, numerous issues concerning the treatment of hepatitis B in the population with chronic kidney disease remain unclear and further clinical trials are needed.

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“…After many years of frustration and concern in this area, some good news has finally arrived. Many centers have begun to report that lamivudine can be effective in the treatment of chronic hepatitis B after kidney transplantation (Table 1 [13][14][15][16][17][18][19][20][21][22][23] ). The interest in nucleoside analogue treatment in this setting is not new, having been tried previously with adenine arabinoside, ganciclovir, and famciclovir.…”

mentioning

confidence: 99%

Hepatitis B and renal transplantation: Securing the sword of Damocles

Perrillo

2002

Hepatology

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Efficacy and safety of lamivudine in renal transplant patients with chronic hepatitis B

Cited by 18 publications

References 6 publications

Efficacy and tolerability of lamivudine in hepatitis B infected renal transplant recipients: A single center study

Efficacy and tolerability of lamivudine in hepatitis B infected renal transplant recipients: A single center study

Management of Chronic Hepatitis B in Special Populations: Immunosuppressed Patients and Chronic Kidney Disease

Hepatitis B and renal transplantation: Securing the sword of Damocles

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