Lamivudine prophylaxis against reinfection in liver transplantation for hepatitis B cirrhosis

Gruellier, L; Mutimer, David; Ahmed, M; Brown, David J.; Burroughs, A K; Rolles, K; McMaster, P; Beranek, P.A.; Kennedy, F; Kibbler, H; McPhillips, Penny; Elias, E.; Dusheiko, Geoffrey

doi:10.1097/00042737-199612000-00026

Cited by 93 publications

(130 citation statements)

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“…Lamivudine can reduce the risk of graft infection with HBV after liver transplantation3 4 while the combination of HBIg and lamivudine is even more effective 20. However, initial enthusiasm has been tempered by the recognition of evolving resistance to lamivudine with time, characterised by the YMDD mutations 5.…”

Section: Discussionmentioning

confidence: 99%

“…Long term use of high dose hepatitis B immunoglobulin (HBIg) alone reduces the risk of graft infection with HBV, but this protection is confined largely to those without evidence of active HBV replication at the time of transplant (both serum HBV DNA and hepatitis B e antigen (HBeAg) negative) 2. More recently, the nucleoside analogue lamivudine has been shown to reduce graft infection and damage with HBV3 4 but there is a significant rate of emerging resistance with long term therapy 5…”

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confidence: 99%

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Successful treatment with adefovir dipivoxil in a patient with fibrosing cholestatic hepatitis and lamivudine resistant hepatitis B virus

Walsh

Woodall

Lamy

et al. 2001

Gut

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Fibrosing cholestatic hepatitis (FCH) is a severe clinical and histological variant of hepatitis B virus (HBV) infection seen most commonly in the HBV infected allograft after liver transplantation. Without treatment, FCH is fatal, rapidly and universally. Remission has been reported with lamivudine but is associated with evolving resistance to lamivudine. Adefovir dipivoxil has recently been reported to be a potent and highly eVective inhibitor of HBV replication in both wild-type and lamivudine resistant HBV infection. We report a case of FCH 15 months after liver transplantation for HBV related cirrhosis despite therapy with lamivudine and hepatitis B immunoglobulin (HBIg). Within two weeks of commencing treatment with adefovir dipivoxil 10 mg once daily, the patient had made a remarkable recovery with resolution of jaundice and normalisation of liver biochemistry. HBV DNA and hepatitis B e antigen were lost from serum subsequently and liver histology had improved at four months. This case report suggests firstly, that advanced FCH can be reversed and secondly, that addition of adefovir dipivoxil to lamivudine and HBIg may be an eVective antiviral strategy. (Gut 2001;49:436-440)

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Successful treatment with adefovir dipivoxil in a patient with fibrosing cholestatic hepatitis and lamivudine resistant hepatitis B virus

Walsh

Woodall

Lamy

et al. 2001

Gut

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“…Thus, in the past, many centres have refused transplantation to HBV DNA positive patients. However, lamivudine has revolutionised our thinking as it has been shown to render patients HBV DNA negative pre-transplant and reduce HBV recurrence post-transplant 23. The major problem has been development of resistance to lamivudine.…”

Section: Hepatitis B Virusmentioning

confidence: 99%

Update on chronic viral hepatitis

Walsh

Alexander

2001

Postgraduate Medical Journal

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Many recent and significant advances in the field of chronic viral hepatitis, including therapy, suggest that an update on chronic hepatitis is timely.Chronic hepatitis B virus infection remains a significant worldwide cause of liver cirrhosis and hepatocellular carcinoma, despite the wide availability of a long established and eVective vaccine. Transmission occurs via perinatal, sexual, and parenteral routes (particularly intravenous drug abuse and although blood products still carry a risk, this is now extremely low in Western countries). Only a minority of infected adult cases develop chronic hepatitis but in children under 1 year, 90% develop chronic hepatitis. The clinical spectrum of chronic liver injury ranges from mild inflammation to end stage liver cirrhosis. Interferon alfa has been the mainstay of treatment for patients with active disease but nucleoside analogues (lamivudine and adefovir) are now available with similar eYcacy. Patients with end stage liver disease and hepatocellular carcinoma can be oVered transplantation but infection in the graft is commonplace. The combination of hepatitis B immunoglobulin and newer antiviral drugs reduce the incidence and severity of graft infection significantly.The hepatitis C virus epidemic of the latter half of the 20th century now aVects more than 1% of populations worldwide. This RNA virus is spread parenterally and is becoming the leading indication for liver transplantation. The majority of patients develop chronic hepatitis, which may be progressive, evolving to significant liver disease (cirrhosis or hepatocellular carcinoma) in about 20% cases after decades. Treatment with the combination of interferon alfa and ribavirin is successful in up to 40% cases. Liver transplantation is a therapeutic option for some but graft infection is universal and often complicated by progressive liver fibrosis. A vaccine remains a remote prospect so that prevention is crucial.Hepatitis D virus infection occurs on a background of hepatitis B virus infection and can also cause liver damage. The response to antiviral therapy is poor.The newer "hepatitis" viruses G and TT do not cause significant liver injury. (Postgrad Med J 2001;77:498-505) Keywords: hepatitis A number of viruses are known to cause chronic hepatitis. These include hepatitis B and D viruses identified in the 1960s and 1970s respectively and hepatitis C virus isolated in 1989. More recently, newer "hepatitis" viruses such as hepatitis G and TTV have been described, although their role in chronic hepatitis is in doubt. Hepatitis A virus does not cause chronic infection. Hepatitis B virusEPIDEMIOLOGY Chronic hepatitis B virus (HBV) infection accounts for 5%-10% of cases of chronic liver disease and cirrhosis in the United States.1 It aVects 350 million people worldwide. The major modes of transmission of HBV are perinatal, sexual (via semen and vaginal secretions), via blood products, and via contaminated needles in intravenous drug addicts. A recent US study found that the prevalence of HBV infect...

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“…Co-infection with hepatitis delta virus (HDV) is advantageous for both disease recurrence and survival. Lamivudine has potential use in optimising the outcome after transplantation 171. However, concerns about the emergence of HBV variants with resistance to this agent, when used as monotherapy, are now prevalent.…”

Section: 0 Liver Transplantationmentioning

confidence: 99%

Indications for referral and assessment in adultliver transplantation: a clinical guideline

Devlin

O’Grady

1999

Gut

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Lamivudine prophylaxis against reinfection in liver transplantation for hepatitis B cirrhosis

Cited by 93 publications

References 0 publications

Successful treatment with adefovir dipivoxil in a patient with fibrosing cholestatic hepatitis and lamivudine resistant hepatitis B virus

Successful treatment with adefovir dipivoxil in a patient with fibrosing cholestatic hepatitis and lamivudine resistant hepatitis B virus

Update on chronic viral hepatitis

Indications for referral and assessment in adultliver transplantation: a clinical guideline

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