title: Limited efficacy of lamivudine against hepatitis B virus infection in allogeneic hematopoietic stem cell transplant recipients.
abstract: BACKGROUND
  Reactivation of chronic hepatitis B virus (HBV) infection is a major complication when HBV carriers receive immunosuppressive therapy. Recipients of allogeneic hematopoietic stem cell transplantation (HSCT) carry the highest risk of fatal HBV disease (up to 12%).
  
  
  METHODS
  In an attempt to identify a suitable procedure for the prevention and management of HBV reactivation, the administration of lamivudine over the course was tested in two patients.
  
  
  RESULTS
  Generally, the patients transplant courses were successfully managed despite their difficult clinical situations: a high HBV load before transplant in one patient and intense steroid therapy for complicated acute graft-versus-host disease (GVHD) in the other patient. However, one patient showed a reactivation of HBV after discontinuing lamivudine and the other showed persistently high DNA polymerase activity despite prolonged administration of lamivudine.
  
  
  CONCLUSIONS
  We concluded that lamivudine could have a place in the management of patients who suffer from chronic HBV infection and who are undergoing allogeneic HSCT. However, the efficacy of lamivudine seemed to be limited compared with other settings, including solid organ transplantation and autologous HSCT.
authors.affiliation: Stem Cell Transplant Unit, and Hematology Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
authors.forename: Mutsuko
authors.initials: M
authors.lastname: Ohnishi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
authors.forename: Toshio
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Sung
authors.initials: S
authors.lastname: Won Kim
authors.forename: Akiko
authors.initials: A
authors.lastname: Hori
authors.forename: Hironari
authors.initials: H
authors.lastname: Niiya
authors.forename: Aki
authors.initials: A
authors.lastname: Chizuka
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Nakai
authors.forename: Takeshi
authors.initials: T
authors.lastname: Saito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Makimoto
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tanosaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Kensei
authors.initials: K
authors.lastname: Tobinai
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Takaue
authors.forename: Shin
authors.initials: S
authors.lastname: Mineishi
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects; D004279:DNA, Viral / Q000097:blood; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects / Q000627:therapeutic use*; D014184:Transplantation, Homologous
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D019259:Lamivudine