Lamivudine therapy of chronic hepatitis B in three groups of patients: non transplanted patients, liver recipients, and kidney recipients.
OBJECTIVE
As conflicting results have been observed by some authors in liver recipients, the aim of the study was to evaluate lamivudine therapy in 3 groups of patients with chronic hepatitis B: non-transplanted patients, liver and kidney recipients.


METHODS
All patients were studied for clinical symptoms, hepatic enzymes, hepatitis B virus (HBV) serology, serum HBV DNA load, and HBV polymerase genotype (mutations associated with lamivudine resistance).


RESULTS
During the 48-144 week-long follow-up (mean: 75 weeks), 23 non-transplanted patients, 5 liver and 6 kidney recipients were studied. A sustained biochemical and virological response was obtained in 19 out of the 23 non-transplanted patients and in 4 of 6 kidney recipients, while the 5 liver recipients did not respond. After the development of lamivudine resistance, mutations rtM204V and rtL180M were detected in all studied patients, mutation rtM207I in one, with similar results from traditional nucleotide sequencing and a commercial line probe assay.


CONCLUSIONS
The poor response to lamivudine in liver recipients requires further studies.
Schvoerer
Evelyne
E
Laboratoire de Virologie, Université Victor-Ségalen, Bordeaux, France.
Kabissa
Imed
I
Cotto
Emmanuelle
E
Jouvencel
Anne-Christine
AC
Balabaud
Charles
C
De Ledinghen
Victor
V
Couzigou
Patrice
P
Quinton
André
A
Schvoerer
Claire
C
Lafon
Marie-Edith
ME
Fleury
Hervé
H
Bernard
Pierre-Henri
PH
D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D004352:Drug Resistance, Microbial / Q000235:genetics; D005260:Female; D015684:Gene Products, pol / Q000235:genetics; D006515:Hepatitis B virus / Q000201:enzymology / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D016030:Kidney Transplantation; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D009154:Mutation; D012189:Retrospective Studies; D016896:Treatment Outcome
D004279:DNA, Viral; D015684:Gene Products, pol; C066027:P protein, Hepatitis B virus; D019259:Lamivudine; D000410:Alanine Transaminase