November 1, 1999Liver Transplantation and Surgery
Lamivudine therapy in patients undergoing liver transplantation for hepatitis b virus precore mutant-associated infection: High resistance rates in treatment of recurrence but universal prevention if used as prophylaxis with very low dose hepatitis B immu
Authors
Discussion
Loading...
Member takes
Implication
Comparative study reveals complete prevention with lamivudine prophylaxis versus high resistance during recurrence treatment in liver transplant recipients, highlighting the need for early prevention.
Key Points
- To evaluate the efficacy of lamivudine combined with low-dose hepatitis B immune globulin for prophylaxis versus lamivudine rescue monotherapy for recurrent precore mutant hepatitis B virus post-transplantation.
- Assessed outcomes across 29 patients undergoing liver transplantation for precore mutant hepatitis B virus infection.
- Compared three cohorts: untreated controls (group 1, n = 10), patients receiving rescue lamivudine after post-transplant recurrence (group 2, n = 10), and patients receiving immediate lamivudine plus low-dose hepatitis B immune globulin prophylaxis (group 3, n = 9).
- In the untreated group, recurrent infection occurred in 9 of 10 patients with subsequent graft loss in all 9; in the rescue group, recurrence developed at a mean of 7.3 months, and 6 of 10 patients developed HBV polymerase gene resistance mutations over a median 11-month follow-up, causing 2 liver failure-related deaths.
- In the prophylaxis group, all 8 surviving patients remained hepatitis B surface antigen negative and HBV DNA negative at a mean follow-up of 15.6 months (1 patient died from graft-versus-host disease).
Cite This Study
McCaughan et al. (1999) studied this question.