Successful Treatment of Hepatitis B Virus Infection With Lamivudine After Heart Transplantation
Journal
Transplantation Proceedings
Journal Volume
38
Journal Issue
7
Pages
2138-2140
Date Issued
2006
Author(s)
Tsao C.I.
Ko W.J.
Lai M.Y.
Chu S.H.
Abstract
Patients with hepatitis B virus (HBV) infection have a higher morbidity and mortality after heart transplantation (HT). HBV infection is endemic in Taiwan. We studied the effect of lamivudine treatment of HBV infection after HT. From July 1987 to July 2005, 252 patients underwent HT. All recipients and donors underwent routine screening of hepatitis B surface antigen (HBsAg), hepatitis B e antigen, antibody to hepatitis B surface antigen, antibody to hepatitis B core antigen, antibody to hepatitis B e antigen, and an alanine aminotransferase (ALT) level before HT. When ALT was two times greater than the upper limit of normal or serum bilirubin was higher than 3 mg/dL in HBsAg-positive patients, HBV-DNA were checked by a branched DNA assay or polymerase chain reaction. When HVB-DNA was greater than 100,000 copies/mL, lamivudine (100 mg per day) was prescribed indefinitely. There were 14 patients under lamivudine treatment after HT, among whom, none suffered severe adverse reactions from lamivudine. Four patients died: one due to end-stage cirrhosis while awaiting liver transplantation at 14 months after HT. Two died of sudden death at 54 months and 138 months after HT. Another died of diffuse B cell lymphoma at 62 months after HT. All the survivors have normal ALT and undetectable HBV-DNA after lamivudine treatment. But the YMDD mutant was detected in two patients. With successful treatment of HBV infection in HT, it is not necessary to exclude HBV infection patients from HT. ? 2006 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
alanine aminotransferase; hepatitis B core antibody; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis B(e) antibody; hepatitis B(e) antigen; lamivudine; adult; article; B cell lymphoma; bilirubin blood level; cardiac graft rejection; clinical article; disease exacerbation; DNA determination; DNA virus; drug efficacy; female; heart transplantation; hepatitis B; Hepatitis B virus; human; leukopenia; liver cirrhosis; liver function test; male; morbidity; mortality; polymerase chain reaction; postoperative complication; priority journal; Taiwan; treatment outcome; treatment response; virus infection; virus mutant; Adult; Antiviral Agents; Female; Follow-Up Studies; Heart Transplantation; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis C; Humans; Lamivudine; Male; Middle Aged; Retrospective Studies; Survival Analysis; Time Factors; Treatment Outcome
Type
journal article