Lamivudine for treating active hepatitis B in renal transplant recipients: a case report.
OBJECTIVE
Chronic hepatitis B is still a matter of concern among renal transplantation patients and patients waiting for a renal transplant since it influences negatively morbidity and mortality. Morbidity and mortality are associated with HBV replication. Lamivudine is a new antiviral agent whose use has been advocated to treat HBV-infected liver transplanted patients.


METHODS
Here we present our experience with an HBV-positive kidney-liver transplanted patient treated with lamivudine after transplantation.


RESULTS
After lamivudine was started HBV-DNA became negative (chemiluminescence, Digene Hybrid Capture System, USA 1997) and ALT levels returned to normal. After eighteen months and after steroid pulses treatment for acute rejection, HBV-DNA became positive again, probably due to virus mutation. Lamivudine treatment was not withdrawn since it has been suggested that the mutant form might be less pathogenic than the wild one. To this extent, more than 10 months after, our patient is still in a good clinical general condition and still takes lamivudine 75 mg/day. No lamivudine-related side effects were recorded.


CONCLUSIONS
Our case confirms that lamivudine is a safe and useful tool in treating renal transplant recipients with chronic hepatitis B.
Manani
S M
SM
Divisione di Nefrologia, Ospedale di Monselice, PD, Italy.
Fabbian
F
F
Catalano
C
C
Bordin
V
V
Vogel
W
W
Di Landro
D
D
D006509:Hepatitis B / Q000188:drug therapy*; D006801:Humans; D016030:Kidney Transplantation; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine