Disappearance of hepatitis B virus core deletion mutants and successful combined kidney/liver transplantation in a patient treated with lamivudine

被引：8

作者：

Meisel, H ^{[1
]}

Preikschat, P ^{[1
]}

Reinke, P ^{[1
]}

Hocher, B ^{[1
]}

Budde, K ^{[1
]}

Bechstein, WO ^{[1
]}

Neuhaus, P ^{[1
]}

Krüger, DH ^{[1
]}

Neumayer, NN ^{[1
]}

机构：

[1] Humboldt Univ, Dept Med Virol, Charite, D-13353 Berlin, Germany

来源：

TRANSPLANT INTERNATIONAL | 1999年 / 12卷 / 04期

关键词：

kidney transplantation; hepatitis B core deletion mutants; lamivudine; famciclovir; combined kidney-liver transplantation;

D O I：

10.1111/j.1432-2277.1999.tb01216.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Hepatitis B virus (HBV) core deletion variants with enhanced viral replication are associated with rapid deterioration of liver function in renal allograft recipients. Antiviral agents such as famciclovir and lamivudine offer new treatment strategies for these patients. Appearance, accumulation and persistence of HBV core deletion mutants were closely monitored in a kidney transplant recipient with liver cirrhosis before and after initiation of antiviral treatment. Under treatment with famciclovir HBV DNA concentration decreased by 50%, HBV mutants persisted. After replacement of famciclovir by lamivudine HBV replication was reduced below the detection limit. Lamivudine was well tolerated and liver function improved. After successful combined kidney/liver transplantation the patient became HBsAg and HBV DNA (detected by PCR) negative under continuous hyperimmune globulin and lamivudine treatment. Antiviral therapy with lamivudine may be useful in treatment of progressive liver disease associated with HBV core deletion mutants in renal allograft recipients and may enable successful liver transplantation.

引用

页码：283 / 287

页数：5

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