Lamivudine treatment of advanced and decompensated liver disease due to hepatitis B
Van Thiel, D.H.; Friedlander, L.; Kania, R.J.; Molloy, P.J.; Hassanein, T.; Wahlstrom, E.; Faruki, H.
Hepato-Gastroenterology 44(15): 808-812
1997
ISSN/ISBN: 0172-6390 PMID: 9222695 Document Number: 473837
The purpose of this study was to evaluate the effectiveness and safety of lamivudine treatment in patients with advanced and end-stage liver disease caused by hepatitis B. Nine cases of advanced or end-stage liver disease due to hepatitis B infection were treated with lamivudine. Four received liver transplants while receiving lamivudine. Moreover, each of these four has been maintained on lamivudine therapy post-transplantation while receiving immunosuppression. No cases of HBV reactivation have been seen. More importantly, the allograft liver tissue has been HBc and HBs antigen negative as well as HBV-DNA negative by PCR. This report suggests that: 1) lamivudine can be given safely to liver transplant candidates,- 2) lamivudine suppresses HBV replication, so much so that HBV-DNA becomes undetectable in the serum; 3) despite powerful immunosuppression associated with transplantation, HBV reactivation does not occur under lamivudine therapy; and 4) the observations should cause transplant physicians, surgeons and third-party payers to reconsider their positions relative to transplantation of individuals with HBV-associated cirrhosis.