title: Lamivudine treatment of advanced and decompensated liver disease due to hepatitis B.
abstract: 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.
authors.affiliation: Department of Medicine, University of Kentucky School of Medicine, Lexington, USA.
authors.forename: D H
authors.initials: DH
authors.lastname: Van Thiel
authors.forename: L
authors.initials: L
authors.lastname: Friedlander
authors.forename: R J
authors.initials: RJ
authors.lastname: Kania
authors.forename: P J
authors.initials: PJ
authors.lastname: Molloy
authors.forename: T
authors.initials: T
authors.lastname: Hassanein
authors.forename: E
authors.initials: E
authors.lastname: Wahlstrom
authors.forename: H
authors.initials: H
authors.lastname: Faruki
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine