Effect of Lamivudine Treatment in Renal Transplant Recipient with HBsAg-Positivity / 대한신장학회잡지
Korean Journal of Nephrology
;
: 999-1006, 2006.
Article
Dans Coréen
| WPRIM
| ID: wpr-68003
ABSTRACT
BACKGROUND:
Immunosuppressive therapy after renal transplantation stimulates the replication of hepatitis B virus (HBV) and may lead to increased liver-related mortality. We investigated the effectiveness of lamivudine for the treatment of HBV reactivation in renal transplant recipients.METHODS:
We reviewed the clinical course of 16 HBsAg-positive renal transplant patients (MF=133) treated with lamivudine for chronic hepatitis B. The outcome of prophylactic (HBV-DNA negative, n=5) and preemptive (HBV-DNA positive, n=4) therapy without hepatic dysfunction was analyzed in compared with that of salvage (n=7) therapy for post-transplantation hepatic dysfunction.RESULTS:
Chronic hepatitis developed in four (25 %) of the enrolled 16 recipients, including one fulminant hepatic failure in prophylactic group and one hepatocellular carcinoma in the salvage group. We found that three (33%) of 9 patients under prophylactic and preemptive therapy showed post-transplantation hepatic dysfunction, but that only one (14%) of 7 patients showed elevated liver enzyme after salvage therapy. During a mean follow-up, under prophylactic and preemptive therapy, of 38 months, five (56%) of 9 patients showed resistance to lamivudine. In seven patients under salvage therapy for a mean follow-up of 26 months, only one patient (14%) showed resistance. At the last follow-up, liver enzyme levels were normal in 14 patients (87.5%).CONCLUSION:
It may be beneficial to use lamivudine for the prevention of liver-related mortality in renal transplant recipients with HBs-Ag positivity. Prophylactic and preemptive lamivudine therapy tend to show higher viral resistance compared with salvage therapy.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Transplantation
/
Virus de l'hépatite B
/
Études de suivi
/
Mortalité
/
Transplantation rénale
/
Thérapie de rattrapage
/
Défaillance hépatique aigüe
/
Carcinome hépatocellulaire
/
Lamivudine
/
Hépatite B chronique
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
langue:
Coréen
Texte intégral:
Korean Journal of Nephrology
Année:
2006
Type:
Article
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