Lamivudine treatment for hepatitis B in dialysis population

case reports and literature review.

F. Fabrizi, S. Mangano, T. Stellato, Paul Martin, P. Messa

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 lamivudine-resistant 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 last-generation nucleos(t)ide analogues for anti-HBV therapy in dialysis population.

Original languageEnglish
Pages (from-to)423-428
Number of pages6
JournalActa Gastro-Enterologica Belgica
Volume76
Issue number4
StatePublished - Jan 1 2013

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Lamivudine
Hepatitis B
Dialysis
Population
Hepatitis B Surface Antigens
Therapeutics
Hepatitis B e Antigens
Viremia
Serum
Chronic Hepatitis B
Transaminases
Viral Load
Chronic Renal Insufficiency
Nucleosides
Kidney Transplantation
Antiviral Agents
Liver Diseases
Reference Values
Clinical Trials
Transplants

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, Paul; Messa, P.

In: Acta Gastro-Enterologica Belgica, Vol. 76, No. 4, 01.01.2013, p. 423-428.

Research output: Contribution to journalArticle

Fabrizi, F. ; Mangano, S. ; Stellato, T. ; Martin, Paul ; Messa, P. / Lamivudine treatment for hepatitis B in dialysis population : case reports and literature review. In: Acta Gastro-Enterologica Belgica. 2013 ; Vol. 76, No. 4. pp. 423-428.
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