Dragan Delic

Ivan Boricic

Jasmina Simonovic-Babic

Nada Tomanovic

Natasa Popovic

Neda Stojkovic-Svirtlih

Nikola Mitrovic

Srpski Arhiv za Celokupno Lekarstvo

Introduction. Reactivation of chronic hepatitis B virus (HBV) infection often
   occurs in hepatitis B surface antigen (HBsAg) positive patients undergoing
   immunosuppressive or chemotherapy, but can also occur in HBsAg negative,
   anti-HB core positive patients. Treatment of HBV reactivation with lamivudin
   results in favourable outcome in the majority of patients. The aim of the
   authors was to show the effect of lamivudin therapy to HBV reactivation
   caused by immunosuppressive therapy. Outline of Cases. The first patient was
   a 35-year-old woman with chronic hepatitis B virus infection who underwent
   prednisolone therapy for pulmonal sarcoidosis. Four months after the
   beginning of the therapy she presented with jaundice and a significant
   increase in serum aminotransferase level. Liver biopsy showed chronic viral B
   hepatitis of strong activity in the stage of rapidly developed cirrhosis. The
   patient was treated with lamivudine with slow reduction of prednisolone
   doses, which resulted in full clinical and biochemical recovery. The second
   patient was a 40-year-old HBsAg negative female with a previous history of
   resolved acute B hepatitis who received chemotherapy for non-Hodgkin
   lymphoma. After the third cycle of chemotherapy a significant increase in
   aminotransferase level occurred, chemotherapy was discontinued, but
   aminotransferase level still increased. At that moment she was found to be
   HBsAg positive, and PCR analysis detected a high viral load. Lamivudine
   treatment resulted in the patient?s recovery and allowed further
   chemotherapy. Conclusion. In case of the reactivation of chronic HBV
   infection during immunosuppressive therapy, it should be stopped and
   antiviral therapy should be immediately initiated. The use of lamivudine
   results in rapid suppression of serum HBV DNA, improves the outcome and
   enables the continuation of immunosuppressive and chemotherapy.</jats:p

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Srpski arhiv za celokupno lekarstvo

The efficacy of lamivudine in the treatment of reactivation of chronic hepatitis B virus infection in patients on immunosuppressive therapy

The efficacy of lamivudine in the treatment of reactivation of chronic hepatitis B virus infection in patients on immunosuppressive therapy

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