Beneficial Effects of Short‐Term Lamivudine Treatment for de novo Hepatitis B Virus Reactivation After Liver Transplantation

Clearance of hepatitis B surface antigen (HBsAg) by lamivudine is achieved in only a small proportion of patients with chronic hepatitis B virus (HBV) infection. We investigated the effect of lamivudine on de novo HBV reactivation after living‐donor liver transplantation when the number of HBV was expected to be very small. Thirty‐eight HBV‐naive recipients who received liver grafts from antibodies to core antigen‐positive donors receiving hepatitis B immunoglobulin (HBIG) were studied. HBsAg appeared in nine cases (23.7 %) despite receiving HBIG for 12–71 months (mean: 35.1 months) after transplantation. Lamivudine treatment was started in six recipients during the acute phase of HBV reactivation. Five of the six recipients achieved complete clearance of HBsAg in sera at a median of 4.6 months (ranging from 21 to 330 days) after lamivudine administration. Although lamivudine was stopped in four cases, all remained negative for HBsAg. Our findings suggested that short‐term lamivudine treatment during acute phase of HBV reactivation could achieve complete clearance of HBsAg in a significant number of liver transplant recipients.

[1]  J. Aranda‐Michel,et al.  Case Report of Lamivudine‐Resistant Hepatitis B Virus Infection Post Liver Transplantation from a Hepatitis B Core Antibody Donor , 2006, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[2]  G. Farr,et al.  Does lamivudine prophylaxis eradicate persistent HBV DNA from allografts derived from anti‐HBc‐positive donors? , 2003, Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[3]  Ching-Lung Lai,et al.  Long-term safety of lamivudine treatment in patients with chronic hepatitis B. , 2003, Gastroenterology.

[4]  D. Samuel,et al.  Antibodies to hepatitis B surface antigen prevent viral reactivation in recipients of liver grafts from anti-HBC positive donors , 2002, Gut.

[5]  C. Bréchot,et al.  Persistent hepatitis B virus infection in subjects without hepatitis B surface antigen: Clinically significant or purely “occult”? , 2001, Hepatology.

[6]  D. Samuel,et al.  Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: A concise review , 2000, Hepatology.

[7]  R. Tur-kaspa,et al.  Lamivudine in the treatment of acute hepatitis B. , 2000, The New England journal of medicine.

[8]  H. Lee,et al.  Hepatitis B e antigen seroconversion after lamivudine therapy is not durable in patients with chronic hepatitis B in Korea , 2000, Hepatology.

[9]  K. Shimotohno,et al.  Latent hepatitis B virus infection in healthy individuals with antibodies to hepatitis B core antigen , 2000, Hepatology.

[10]  D. Pillay,et al.  Outcome of lamivudine resistant hepatitis B virus infection in the liver transplant recipient , 2000, Gut.

[11]  E. Schiff,et al.  Lamivudine as initial treatment for chronic hepatitis B in the United States. , 1999, The New England journal of medicine.

[12]  J. Fung,et al.  Prevention of de novo hepatitis B infection in recipients of hepatic allografts from anti-HBc positive donors. , 1999, Transplantation.

[13]  E. Schiff,et al.  Multicenter study of lamivudine therapy for hepatitis B after liver transplantation , 1999, Hepatology.

[14]  M. Bernardi,et al.  Lamivudine treatment for acute hepatitis B after liver transplantation. , 1998, Journal of hepatology.

[15]  H. Marusawa,et al.  Transmission of hepatitis B virus from hepatitis B core antibody-positive donors in living related liver transplants. , 1998, Transplantation.

[16]  A. Lok,et al.  Hepatitis B virus S mutants in liver transplant recipients who were reinfected despite hepatitis B immune globulin prophylaxis , 1998, Hepatology.

[17]  K. Reddy,et al.  Hepatitis-B-virus resistance to lamivudine given for recurrent infection after orthotopic liver transplantation , 1997, The Lancet.

[18]  L. Ferrell,et al.  "Occult" hepatitis B virus as source of infection in liver transplant recipients , 1994, The Lancet.

[19]  F. Chisari,et al.  Hepatitis B virus persistence after recovery from acute viral hepatitis. , 1994, The Journal of clinical investigation.