Clinical Gastroenterology Vol.19 No.11(1-6)

Theme Hepatitis B Update 2004
Title Prophylactic Lamivudine Administration Prevents Exacerbation of HBV Related Liver Damage in Patients with Hepatocellular Carcinoma Undergoing Transhepatic Arterial Infusion Chemotherapy
Publish Date 2004/10
Author Takuji Torimura Second Department of Medicine, Kurume University School of Medicine
Author Hiroaki Nagamatsu Second Department of Medicine, Kurume University School of Medicine
Author Satoshi Itano Second Department of Medicine, Kurume University School of Medicine
Author Satoru Matsugaki Second Department of Medicine, Kurume University School of Medicine
Author Ryukichi Kumashiro Second Department of Medicine, Kurume University School of Medicine
Author Michio Sata Second Department of Medicine, Kurume University School of Medicine
[ Summary ] A flare up of hepatitis, due to the reactivation of hepatitis B virus (HBV), is a serious complication in patients with malignant diseases receiving chemotherapy. In thirty three patients with HBV-related hepato cellular carcinoma (HCC) who received trans-hepatic arterial chemotherapy, all of the eight patients who were HBe antigen positive were found to have exacerbated liver damage. Of these, three patients died of liver failure. The only associated factor for the excerbation of liver damage was HBe antigen positivity. From the year 2000, prophylactic lamivudine administration was performed on eight patients who were HBe antigen positive HCC prior to trans-hepatic arterial chemotherapy. None of the eight patients who received Lamivudine administration showed exacerbation of liver damage. Lamivudine administration significantly reduced HBV-DNA levels prior to chemotherapy (base line ; 6.6+-1.0 LGE/ml, prior to chemotherapy; 4.7+-1.0 LGE/ml). AST and ALT levels in the lamivudine-treated group did not change throughout chemotherapy. Total bilirubin and prothrombin time levels also did not show any significant change throughout chemotherapy. These results indicate that prophylactic lamivudine administration reduces HBV-DNA levels and prevents exacerbation of liver damage throughout the period of chemotherapy in HBe antigen positive patients with HCC.
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