Role of lamivudine in the reactivation of hepatitis B virus infection in immunodepressed patients.
BACKGROUND
hepatitis B virus (HBV) reactivation in immunocompromised states is a well-known event that may be a serious problem in endemic areas of infection. Presently, the investigation of hepatitis B status has been recommended prior to receiving cytotoxic treatment. Lamivudine has been used in the reactivation of HBV in immunocompromised states. We report our corresponding data for lamivudine in the treatment of HBV reactivation after intensive chemotherapy in patients with lymphoma and after kidney transplantation.


METHODS
we present two cases of HBV reactivation after chemotherapy for lymphoma and two cases after cadaveric renal transplantation treated with lamivudine (100-150 mg/day).


RESULTS
we observed a prompt clinical improvement in all patients after lamivudine treatment. Furthermore, laboratory data showed a rapid biochemical and antiviral response. However, the response in lymphoma patients was quicker than in patients who had post-transplantation reactivation of HBV. Therapy was well tolerated and no relevant side effects appeared during follow-up (twenty four months). The HBV remained negative in three cases.


CONCLUSIONS
lamivudine is effective and safe in the treatment of HBV reactivation in immunodepressed patients. Lamivudine therapy should be considered for the treatment of HBV reactivation in patients with prior hepatitis B or chronic hepatitis B with inactive viral replication.
Martín
E
E
Servicio de Aparato Digestivo. Hospital Universitario Puerta del Mar. Cádiz. Spain. diges.hpm.sspa@juntadeandalucia.es
Rendón
P
P
De Diego
L
L
Soria
M J
MJ
Martínez
M C
MC
Martín
L
L
D000328:Adult; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine