Abstract
It is well known that chronic hepatitis B plays a detrimental role on survival in patients on long-term dialysis and after kidney transplantation. The advent of nucleos(t)ide analogues offers the opportunity to change the natural history of hepatitis B in patients with chronic kidney disease. We report our experience on lamivudine use in two patients with HBV-related liver disease on long-term dialysis. At the beginning, both the patients were HBsAg positive and HBeAg positive with high viral load; after long-term lamivudine therapy, clearance of HBV viremia from serum was observed in both. Raised aminotransferase levels fell into the normal range and one patient experienced clearance of HBsAg by anti-HBV therapy. Tolerance to lamivudine was satisfactory and lamivudine resistance was not detected. Information on antiviral therapy with lamivudine in HBsAg positive patients on regular dialysis is extremely limited; we identified by an extensive review of the literature five studies with a total of 38 unique patients, most of them being renal transplant candidates. Lamivudine proved to be effective as the clearance of HBV viraemia from serum ranged between 56% and 100%; the clearance of HBeAg from serum was less evident (between 37.5% and 100%). No significant side-effects due to lamivudine were observed and emergence of lamivudineresistant strains was observed in two (5%) patients. Only a minority of patients experienced HBsAg loss (13%). We conclude that anti- HBV treatment with a nucleoside analogue such as lamivudine gives satisfactory results in some patients on long-term dialysis. Clinical trials are in progress to assess efficacy and safety of lastgeneration nucleos(t)ide analogues for anti-HBV therapy in dialysis population.
| Original language | English |
|---|---|
| Pages (from-to) | 423-428 |
| Number of pages | 6 |
| Journal | Acta Gastro-Enterologica Belgica |
| Volume | 76 |
| Issue number | 4 |
| Publication status | Published - 2013 |
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Keywords
- Dialysis
- Hbv viraemia
- Hepatitis b
- Lamivudine
ASJC Scopus subject areas
- Gastroenterology
Cite this
Lamivudine treatment for hepatitis b in dialysis population : Case reports and literature review. / Fabrizi, F.; Mangano, S.; Stellato, T.; Martin, P.; Messa, P.
In: Acta Gastro-Enterologica Belgica, Vol. 76, No. 4, 2013, p. 423-428.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lamivudine treatment for hepatitis b in dialysis population
T2 - Case reports and literature review
AU - Fabrizi, F.
AU - Mangano, S.
AU - Stellato, T.
AU - Martin, P.
AU - Messa, P.
PY - 2013
Y1 - 2013
N2 - It is well known that chronic hepatitis B plays a detrimental role on survival in patients on long-term dialysis and after kidney transplantation. The advent of nucleos(t)ide analogues offers the opportunity to change the natural history of hepatitis B in patients with chronic kidney disease. We report our experience on lamivudine use in two patients with HBV-related liver disease on long-term dialysis. At the beginning, both the patients were HBsAg positive and HBeAg positive with high viral load; after long-term lamivudine therapy, clearance of HBV viremia from serum was observed in both. Raised aminotransferase levels fell into the normal range and one patient experienced clearance of HBsAg by anti-HBV therapy. Tolerance to lamivudine was satisfactory and lamivudine resistance was not detected. Information on antiviral therapy with lamivudine in HBsAg positive patients on regular dialysis is extremely limited; we identified by an extensive review of the literature five studies with a total of 38 unique patients, most of them being renal transplant candidates. Lamivudine proved to be effective as the clearance of HBV viraemia from serum ranged between 56% and 100%; the clearance of HBeAg from serum was less evident (between 37.5% and 100%). No significant side-effects due to lamivudine were observed and emergence of lamivudineresistant strains was observed in two (5%) patients. Only a minority of patients experienced HBsAg loss (13%). We conclude that anti- HBV treatment with a nucleoside analogue such as lamivudine gives satisfactory results in some patients on long-term dialysis. Clinical trials are in progress to assess efficacy and safety of lastgeneration nucleos(t)ide analogues for anti-HBV therapy in dialysis population.
AB - It is well known that chronic hepatitis B plays a detrimental role on survival in patients on long-term dialysis and after kidney transplantation. The advent of nucleos(t)ide analogues offers the opportunity to change the natural history of hepatitis B in patients with chronic kidney disease. We report our experience on lamivudine use in two patients with HBV-related liver disease on long-term dialysis. At the beginning, both the patients were HBsAg positive and HBeAg positive with high viral load; after long-term lamivudine therapy, clearance of HBV viremia from serum was observed in both. Raised aminotransferase levels fell into the normal range and one patient experienced clearance of HBsAg by anti-HBV therapy. Tolerance to lamivudine was satisfactory and lamivudine resistance was not detected. Information on antiviral therapy with lamivudine in HBsAg positive patients on regular dialysis is extremely limited; we identified by an extensive review of the literature five studies with a total of 38 unique patients, most of them being renal transplant candidates. Lamivudine proved to be effective as the clearance of HBV viraemia from serum ranged between 56% and 100%; the clearance of HBeAg from serum was less evident (between 37.5% and 100%). No significant side-effects due to lamivudine were observed and emergence of lamivudineresistant strains was observed in two (5%) patients. Only a minority of patients experienced HBsAg loss (13%). We conclude that anti- HBV treatment with a nucleoside analogue such as lamivudine gives satisfactory results in some patients on long-term dialysis. Clinical trials are in progress to assess efficacy and safety of lastgeneration nucleos(t)ide analogues for anti-HBV therapy in dialysis population.
KW - Dialysis
KW - Hbv viraemia
KW - Hepatitis b
KW - Lamivudine
UR - http://www.scopus.com/inward/record.url?scp=84897940003&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897940003&partnerID=8YFLogxK
M3 - Article
C2 - 24592546
AN - SCOPUS:84897940003
VL - 76
SP - 423
EP - 428
JO - Acta Gastro-Enterologica Belgica
JF - Acta Gastro-Enterologica Belgica
SN - 0001-5644
IS - 4
ER -