my personal edition > nephrology other > news


  E-Mail this DGDispatch to a colleague

DGDispatch

Lamivudine Therapy Effective for Hepatitis B Viral Infection in Renal Transplant Patients: Presented at ERA-EDTA

By Lynda Jackson

COPENHAGEN, DENMARK -- July 18, 2002 -- Lamivudine therapy promotes a rapid and dramatic improvement in renal transplant patients infected with hepatitis B, researchers report.

Dr. La Salete Martins and colleagues from the department of nephrology, Hospital Santo Antonio, Porto, Portugal, presented the findings here July 17 at the 39^th annual Congress of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).

Lamivudine is a potent inhibitor of DNA transcription and DNA replication. It has been shown to have activity against hepatitis B virus (HBV) replication and to be efficacious without increased risk of acute rejection when used in renal transplant patients.

The researchers conducted a prospective evaluation of seven HBV-infected renal transplant patients treated at Hospital Santo Antonio; all had acquired HBV before transplantation. Hepatic histology was available for four patients.

Inflammation was moderate in two patients and was treated with interferon.

All patients were treated with lamivudine 100 g/day. One patient began lamivudine treatment prior to transplantation and continued the regimen during the post-transplantation evaluation; the remaining six patients began treatment eight months to 15 years after transplantation. In these patients therapy was initiated due to reactivation of hepatitis (four patients), HBV-associated graft glomerulonephritis (one patient), and fibrosing cholestatic hepatitis (one patient).

All patients were HBs antigen positive before and after treatment, HBe antigen remained negative, and plasma creatinine was stable, said Dr. Martins. HBV DNA was negative in five patients and below 24 pg/ml in two, and all patients had normal liver enzymes and normal liver sonography.

There was a rapid improvement after starting treatment, particularly in the cases of glomerulonephritis and cholestatic hepatitis. In the glomerulonephritis patient, graft function significantly improved and the nephritic syndrome disappeared. The patient with cholestatic hepatitis normalized the laboratory markers of hepatic insufficiency, cholestasis, and A1T level.

HBV DNA became negative in all seven patients after three to eight months.

At mean follow-up of 11 months, all patients were still receiving lamivudine, and there were no reported side effects. There was one episode of acute rejection, but it was not due to lamivudine.

The researchers concluded that lamivudine is an effective drug for activated HBV after transplantation and for associated diseases such as fibrosing cholestatic hepatitis or graft glomerulonephritis.

E-Mail this DGDispatch to a colleague

To print, use this version