Reactivation of hepatitis and lamivudine therapy in 11 HBsAg‐positive renal allograft recipients: a single centre experience

Murakami, Reiichi; Amada, Noritoshi; Sato, Tatsuya; Orii, Takashi; Kikuchi, Hiroyuki; Haga, Izumi; Ohashi, Y; Okazaki, H

doi:10.1111/j.1399-0012.2006.00490.x

Cited by 15 publications

(8 citation statements)

References 27 publications

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“…For many viral infections, such as HBV or EBV, resolution of illness is likely mediated by cellular immune responses that provide long‐term host control of viremia rather than viral eradication 33, 34. In HBV infection, it has been shown that virus‐specific cellular immunity contributes to self‐limited disease35 and that suppression of this immune control by chemotherapy or immune suppressive treatment can lead to viral reactivation 17–19. Thus, immune suppressive treatment following solid organ transplantation may place the individual at considerable risk of viral reactivation.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, patients with chronic HBV infection (CHB) show generally weak and narrowly directed virus‐specific cellular immunity that may be functionally impaired 10–13. The initiation of Lamivudine therapy in these subjects has been shown to at least transiently increase clusters of differentiation (CD)4 and CD8 T cell–mediated immune responses against the HBV envelope (HBV surface antigen [HBsAg]) and nucleocapsid antigens (HBV core antigen)14–16 Comparably little is known about the role of the virus‐specific T‐cell responses in the OLT setting, although a deeper understanding of host immunity to HBV in OLT could facilitate the development of novel therapeutic immune interventions 17–19. The present study was thus designed to investigate the HBV‐specific cellular immune response in immune‐suppressed patients (OLT recipients) compared to patients with CHB (viremic and nonviremic) and self‐limited HBV infection.…”

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confidence: 99%

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Sustained and focused hepatitis B virus nucleocapsid–specific T-cell immunity in liver transplant recipients compared to individuals with chronic and self-limited hepatitis B virus infection

et al. 2008

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Hepatitis B virus (HBV) recurrence after orthotopic liver transplantation (OLT) is associated with poor graft-and patientsurvival. Treatment with HBV-specific immunoglobulins (HBIG) in combination with nucleos(t)ide analogs is effective in preventing HBV reinfection of the graft and improving OLT outcome. However, the role of HBV-specific cellular immunity in viral containment in immune suppressed patients in general and in OLT recipients in particular is unclear. To test whether or not OLT recipients maintain robust HBV-specific cellular immunity, the cellular immune response against HBV was assessed in 15 OLT recipients and 27 individuals with chronic and 24 subjects with self-limited HBV infection, respectively; using an overlapping peptide set spanning the viral nucleocapsid-and envelope-protein sequences. The data demonstrate that OLT recipients mounted fewer but stronger clusters of differentiation (CD)8 T cell responses than subjects with self-limited HBV infection and showed a preferential targeting of the nucleocapsid antigen. This focused response pattern was similar to responses seen in chronically infected subjects with undetectable viremia, but significantly different from patients who presented with elevated HBV viremia and who mounted mainly immune responses against the envelope protein. In conclusion, virus-specific CD4 T cell-mediated responses were only detected in subjects with self-limited HBV infection. Thus, the profile of the cellular immunity against HBV was in immune suppressed patients similar to subjects with chronic HBV infection with suppressed HBV-DNA. Liver Transpl 14:478-485, 2008. © 2008 AASLD. Received July 4, 2007 accepted October 6, 2007. Five to ten percent of all orthotopic liver transplantations (OLTs) for end-stage liver disease are related to hepatitis B virus (HBV) infection. 1,2 Recurrent HBV infection after OLT is a major complication, frequently leading to graft failure or patient death. 3 Without prophylaxis, the risk of graft reinfection is about 80%,

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Sustained and focused hepatitis B virus nucleocapsid–specific T-cell immunity in liver transplant recipients compared to individuals with chronic and self-limited hepatitis B virus infection

et al. 2008

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“…We thought that, this may be due to the spesifications of the patient group and may be a result of administring antiviral treatment to all patients. Viral reactivation usually develops in 1st year after transplantation (9,(31)(32)(33). Usage of higher doses of immunosuppressive drugs after Rtx in the 1st year is the major cause of this situation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Yılmaz

Çetinkaya

Akbaş

et al. 2016

International Surgery

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Abstract:Aim: Our aim was to compare the short and long term clinical outcomes of HbsAg(+) renal transplant recipients with HbsAg(-) recipients. Patients and Methods: Two hundered and four patients who underwent renal transplantation in our center between 2001 and 2014 were included in the study. The patients were divided into two groups. Group 1: HbsAg(-) group (n=136) and Group 2: HbsAg(+) group (n=68). There was no significant difference between the groups in terms of lymphocyte cross matches, numbers of mismatches, immunosuppressive treatment protocols and induction treatments. In HbsAg(+) group, 51 patients were HBV DNA(+), 64 patients were HbeAg(-) and 4 patients were HbeAg(+). Fifty-seven (83.8%) patients were treated with Lamivudine, 4 (5.9%) patients with Entecavir and 7 (10.3%) patients with Tenofovir for Hepatitis B infection. Graft and patient survival rates, graft functions, acute hepatitis rates, acute rejection rates and other clinical outcomes of the groups were compared. Results: Demographic data and immuologic risk profiles of the groups were similar. Acute rejection rates, graft survival rates and patient survival rates were similar. Acute hepatitis rates, glomerular filtration rates on the last controls and delayed graft function rates were higher in Group 2, while chronic allograft disfunction and new onset Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationdiabetes mellitus after transplantation (NODAT) rates were similar between the groups. Conclusion: Our study revealed that, graft and patient survival and acute rejection rates were similar between HbsAg(+) and HbsAg(-) recipients, while acute hepatitis rate was higher in HbsAg(+) recipients. Results: Demographic data and immuologic risk profiles of the groups were similar. Acute rejection rates, graft survival rates and patient survival rates were similar. Acute hepatitis rates, glomerular filtration rates on the last controls and delayed graft function rates were higher in Group 2, while chronic allograft disfunction and new onset diabetes mellitus after transplantation (NODAT) rates were similar between the groups. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Conclusion:Our study revealed that, graft and patient survival and acute rejection rates were similar between HbsAg(+) and HbsAg(-) recipients, while acute hepatitis rate was higher in HbsAg(+) recipients.

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“…Our results are not likely to be generalizable to other disease states because of potentially unique rates and timing of HBV reactivation. Future studies should explore the costs and effectiveness of HBV prophylaxis in different disease states such as hepatocellular carcinoma, 46 breast cancer, 47 nasopharyngeal carcinoma, 48 rheumatologic diseases, 49 renal transplants, 50 lung transplants, 51 and inflammatory bowel diseases. 52 In our model, the prophylactic use of lamivudine was associated with 171 fewer HBV reactivations and 28 fewer overall deaths.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B prophylaxis in patients undergoing chemotherapy for lymphoma: A decision analysis model

et al. 2007

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Hepatitis B reactivation is a major cause of morbidity and mortality in patients undergoing chemotherapy for lymphomas. These patients may experience direct liver-related complications or reduced cancer survival because of interruptions in chemotherapy. Our aim was to compare the costs and outcomes of 2 different chronic hepatitis B management strategies. In hepatitis B carriers undergoing chemotherapy, we pursued a decision analysis model to compare the costs and clinical outcomes of using lamivudine prophylaxis versus initiating lamivudine only when clinically overt hepatitis occurred. H epatitis B virus (HBV) infection is an important medical and public health concern, and it is a leading cause of cirrhosis and hepatocellular carcinoma. 1,2 Patients with hepatitis B are at risk of viral reactivation when undergoing cytotoxic or immunosuppressive chemotherapy for malignancies, particularly lymphomas. 3 The incidence of HBV reactivation may be as high as 50% and is associated with an overall liver-related mortality of 5%. 4,5 Even in patients who are able to recover from hepatitis B reactivation, their cancer survival may be impaired because of alterations or cessation of the initially intended chemotherapy course. 6,7 The pathogenesis of HBV reactivation during or after chemotherapy appears to be related to an increase in viral replication during immunosuppression with a resultant increase in hepatocyte destruction and inflammation upon immune reconstitution. [3][4][5] Lamivudine, a nucleoside analogue, has been shown to be effective in inhibiting viral replication and decreasing viral load. [8][9][10] Various strategies have been proposed in patients with hepatitis B undergoing chemotherapy to prevent viral replication. It has been suggested that the earlier use of lamivudine, before overt clinical hepatitis, is most efficacious. 11 The use of prophylactic lamivudine can decrease the incidence of HBV reactivation from 30%-80% to 0%-17%. [12][13][14][15][16][17] The aim of this study was to compare the efficacy and costs of 2 management strategies in patients with hepatitis B undergoing chemotherapy: (1) lamivudine prophylaxis and (2) lamivudine use only in patients with evidence of an HBV reactivation. Because lamivudine has been

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Reactivation of hepatitis and lamivudine therapy in 11 HBsAg‐positive renal allograft recipients: a single centre experience

Abstract: For HBsAg (+) renal allograft recipients, careful monitoring of HBV-DNA levels and timely administration of lamivudine could prevent hepatic damage caused by reactivation of hepatitis.

Cited by 15 publications

References 27 publications

Sustained and focused hepatitis B virus nucleocapsid–specific T-cell immunity in liver transplant recipients compared to individuals with chronic and self-limited hepatitis B virus infection

Sustained and focused hepatitis B virus nucleocapsid–specific T-cell immunity in liver transplant recipients compared to individuals with chronic and self-limited hepatitis B virus infection

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Hepatitis B prophylaxis in patients undergoing chemotherapy for lymphoma: A decision analysis model

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