RESUMO
BACKGROUND/AIMS: Treatment with hepatitis B virus immune globulins (HBIG) or lamivudine has reduced the rate of hepatitis B recurrence after liver transplantation to approximately 50%. METHODS: To further decrease hepatitis B recurrence, 33 hepatitis B virus (HBV)-related cirrhotic patients were treated with lamivudine before liver transplantation and with lamivudine together with low-dose HBIG (46 500 IU the first month followed by 5,000 lU/monthly) after surgery. RESULTS: While on lamivudine, serum HBV DNA level decreased significantly in all patients and in 11 (33%) the Child-Pugh score improved. Twenty-six patients were transplanted. Among the 25 who survived for longer than 12 months, only one (4%) experienced a hepatitis B recurrence over an average follow-up of 31 months, a rate significantly lower (P = 0.0002) than the 50% recurrence rate among a historical control group of 12 patients. However, low-level HBV replication was detected sporadically throughout the follow-up in 64% of patients. CONCLUSIONS: Over the medium-term, combined prophylaxis with lamivudine and HBIG significantly decreases the risk of hepatitis B recurrence after liver transplantation. Though low-level HBV infection recurred in two thirds of patients, the pathogenic expression of HBV was prevented.
Assuntos
Antivirais/uso terapêutico , Anticorpos Anti-Hepatite B/uso terapêutico , Hepatite B/prevenção & controle , Lamivudina/uso terapêutico , Cirrose Hepática/cirurgia , Transplante de Fígado , Adulto , DNA Viral/sangue , Feminino , Hepatite B/terapia , Hepatite B/virologia , Humanos , Imunização Passiva , Imunoglobulinas/uso terapêutico , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/terapia , Transplante de Fígado/efeitos adversos , Masculino , Pessoa de Meia-Idade , RecidivaRESUMO
This study investigated the effects of a Developmental Learning Program upon self-concept of 40 children having trouble in school. While preliminary in nature, the results suggest that such a program may have a beneficial effect.
