Hepatitis B surface antigen (HBsAg)-positive renal transplant patients have improved survival if they are preemptively treated with lamivudine, according to the results of a comparative study reported in the November issue of Hepatology. An editorialist agrees, but emphasizes our limited knowledge of this medication in this setting.
“HBsAg-positive kidney transplant recipients have increased liver-related mortality,” write T. M. Chan and colleagues from the University of Hong Kong.
“The impact of lamivudine treatment on patient survival, the optimal time to start treatment, and the feasibility of discontinuing treatment have not been determined.” Of 509 renal allograft recipients in this study, 67 were HbsAg-positive and 442 were HbsAg-negative. Beginning in January 1996, lamivudine was given preemptively for 32.6 ± 13.3 months to HBsAg-positive kidney transplant recipients with increasing hepatitis B virus (HBV) DNA levels with or without elevation of aminotransferase levels.
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