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Lamivudine therapy for hepatitis B in renal transplantation
F R L Santos1, A R Haiashi, M R T Araújo
1Clínica de Nefrologia, Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil.
Abstract:
Antiviral therapies are associated with an increased risk of acute rejection in transplant patients. The aim of the present study was to evaluate the efficacy and safety of lamivudine therapy for hepatitis B virus (HBV) infection in renal transplant patients. Six patients were included in this study. They received 150 mg/day of lamivudine during a follow-up period of 24 months. The laboratory tests monitored were HBV DNA, HBsAg, HBeAg, ALT, gamma-GT, serum creatinine and blood cyclosporine levels. The HBV DNA became undetectable in four patients as early as in the third month of treatment. After six months, the viral load was also negative in the other two patients, and remained so until 18 months of follow-up. The medication was well tolerated with no major side effects. Lamivudine was safe and effective in blocking HBV replication in renal transplant patients without any apparent increase in the risk of graft failure for the 24-month period of study.
Insights
Lamivudine effectively suppressed hepatitis B virus (HBV) replication in renal transplant recipients. This antiviral therapy demonstrated safety and efficacy over 24 months, with no observed increase in graft failure risk.
Area of Science:
- Nephrology
- Hepatology
- Transplant Medicine
Background:
- Antiviral therapies can increase acute rejection risk in transplant patients.
- Hepatitis B virus (HBV) infection poses a significant challenge in renal transplant recipients.
- Effective management of HBV in this population is crucial for long-term graft survival.
Purpose of the Study:
- To assess the efficacy and safety of lamivudine for treating HBV infection in renal transplant patients.
- To evaluate the impact of lamivudine on HBV viral load and liver function markers.
- To determine the risk of graft rejection or failure associated with lamivudine therapy.
Main Methods:
- A study involving six renal transplant patients receiving 150 mg/day of lamivudine.
- Monitoring of HBV DNA, HBsAg, HBeAg, ALT, gamma-GT, serum creatinine, and cyclosporine levels over 24 months.
- Assessment of treatment tolerability and adverse events.
Main Results:
- HBV DNA became undetectable within three months in four patients.
- All six patients achieved undetectable HBV DNA by six months, maintained through 18 months.
- Lamivudine was well-tolerated with no major side effects reported.
- No apparent increase in graft failure risk was observed during the 24-month follow-up.
Conclusions:
- Lamivudine is a safe and effective treatment for blocking HBV replication in renal transplant patients.
- The study supports the use of lamivudine in managing HBV in this high-risk population.
- Long-term lamivudine therapy appears to not compromise renal graft survival.