Lamivudine treatment for hepatitis B reactivation in HBsAg carriers after organ transplantation: A 4‐year experience

Liu, Chun‐Jen; Lai, Ming‐Yang; Lee, Po‐Huang; Chou, Nai‐Kuan; Chu, Shu‐Hsun; Chen, Pei‐Jer; Jen, Yung-Ming; Chen, Ding‐Shinn

doi:10.1046/j.1440-1746.2001.02532.x

Cited by 35 publications

(27 citation statements)

References 43 publications

(49 reference statements)

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“…However, severe flare up, as was the case in patient No 2, with high levels of bilirubin at presentation, seem to be predictors of treatment failure. 13 A similar scenario was described in two rheumatic patients treated with infliximab. 6 7 In one case clear reactivation of HBV hepatitis was documented 6 ; in the other, who required liver transplantation, no evidence of either serological or histological reactivation of HBV was demonstrated.…”

Section: Discussionmentioning

confidence: 68%

Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis

Esteve

Saro²,

González-Húix³

et al. 2004

Gut

428

280

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Background: There is little information about the effect of infliximab on the clinical course of liver disease in Crohn's disease patients with concomitant hepatitis B virus (HBV) infection. Theoretically, immunosuppression induced by infliximab will facilitate viral replication which could be followed by a flare or exacerbation of disease when therapy is discontinued. There are no specific recommendations on surveillance and treatment of HBV before infliximab infusion. Two cases of severe hepatic failure related to infliximab infusions have been described in patients with rheumatic diseases. Patients and methods: Hepatitis markers (C and B) and liver function tests were prospectively determined to 80 Crohn's disease patients requiring infliximab infusion in three hospitals in Spain. Results: Three Crohn's disease patients with chronic HBV infection were identified. Two of the three patients with chronic HBV infection suffered severe reactivation of chronic hepatitis B after withdrawal of infliximab therapy and one died. A third patient, who was treated with lamivudine at the time of infliximab therapy, had no clinical or biochemical worsening of liver disease during or after therapy. From the remaining 80 patients, six received the hepatitis B vaccine. Three patients had antibodies to both hepatitis B surface antigen (anti-HBs) and hepatitis B core protein (anti-HBc) with normal aminotransferase levels, and one patient had positive anti-hepatitis C virus (HCV) antibodies, negative HCV RNA, and normal aminotransferase levels. Except for the patients with chronic HBV infection, no significant changes in hepatic function were detected. Conclusions: Patients with Crohn's disease who are candidates for infliximab therapy should be tested for hepatitis B serological markers before treatment and considered for prophylaxis of reactivation using antiviral therapy if positive.

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Section: Discussionmentioning

confidence: 68%

Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis

Esteve

Saro²,

González-Húix³

et al. 2004

Gut

428

280

View full text Add to dashboard Cite

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“…By comparison, in the same and in another study, the prognosis of cases of fulminant hepatitis not receiving lamivudine was dismal, with a 100% death rate [12,61]. A bilirubin level $ 3 mg at presentation was identified as a risk factor for the failure of lamivudine [66].…”

Section: Lamivudine As Treatment Of Hbv Reactivationmentioning

confidence: 85%

“…Mutant strain appeared after 36 -60 weeks of treatment. Withdrawal of lamivudine resulted in the remission of hepatitis in three out of three patients [66]. Mutant development may be favoured by HBV DNA positivity on the day of liver transplantation [83].…”

Section: Adverse Effects Of Lamivudine Therapymentioning

confidence: 99%

Prophylaxis with Lamivudine of Hepatitis B Virus Reactivation in Chronic HbsAg Carriers with Hemato-oncological Neoplasias Treated with Chemotherapy

Rossi

2003

Leukemia & Lymphoma

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Reactivation of hepatitis B virus (HBV) infection is well documented complication of cytotoxic or immunosuppressive therapy in asymptomatic HBV carriers. Its clinical manifestation include fulminant hepatitis which may result in fatal liver failure. With the more widespread use of chemotherapy and hematopoietic stem cell transplantation, the problem of delivering potentially harmful treatment to HBV carriers is becoming increasingly frequent. Until recently the management of HBV reactivation has been mainly supportive. With the introduction of lamivudine, a highly effective nucleoside analogue against HBV with an excellent toxicity profile has become available. However, in light of the possibility that its prolonged use may foster the emergence of mutant lamivudine-resistant HBV strain, caution is required before recommending its widespread use. The present review briefly addresses the epidemiological, pathogenetic and clinical aspects of HBV reactivation as well the predisposing factors to its development. The results obtained with lamivudine both as treatment and as prophylaxis of hepatic flares are analysed in detail in order to provide a rational basis for clinical decisions before treating HBV carriers with chemotherapy.

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“…Early treatment should also benefit steroid-use patients for the high mortality of liver decompensation under immunosuppression [28]. If case 3 had been treated earlier, we might not have had to stop the immunosuppressant and the ensuing deterioration of pulmonary fibrosis might not have happened.…”

Section: Discussionmentioning

confidence: 99%

Reactivation of Hepatitis B Virus in Rheumatologic Patients Receiving Immunosuppressive Agents

et al. 2006

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Lamivudine treatment for hepatitis B reactivation in HBsAg carriers after organ transplantation: A 4‐year experience

Abstract: These results indicated that lamivudine is effective in the treatment of post-transplant hepatitis B reactivation, including patients with dual chronic hepatitis B and C. Early recognition of HBV reactivation and prompt lamivudine treatment are important to prevent mortality.

Cited by 35 publications

References 43 publications

Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis

Chronic hepatitis B reactivation following infliximab therapy in Crohn's disease patients: need for primary prophylaxis

Prophylaxis with Lamivudine of Hepatitis B Virus Reactivation in Chronic HbsAg Carriers with Hemato-oncological Neoplasias Treated with Chemotherapy

Reactivation of Hepatitis B Virus in Rheumatologic Patients Receiving Immunosuppressive Agents

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