Abstract | BACKGROUND: AIM: To review current randomized-controlled trials, randomized trials and prospective case series to provide a clinically applicable, evidence-based recommendation. METHODS: The published literature was identified using a MEDLINE/PubMed search with secondary review of cited publications, and inclusion of all prospective studies. RESULTS: In nine prospective trials and one randomized-controlled trial, the rate of hepatitis among subjects receiving lamivudine prophylaxis ranged from 0% to 20% (16 of 173, 9.2%), compared with 33-67% among controls. Of patients receiving prophylaxis, 0-24% (15 of 173, 8.7%) developed hepatitis B virus reactivation, compared with 29-56% of controls. Three reactivation-related mortalities were reported (one receiving prophylaxis, two controls). No patients withdrew secondary to toxicity or development of lamivudine-resistant mutations. CONCLUSIONS: The available data show a four- to sevenfold decrease in the rate of hepatitis and hepatitis B virus reactivation in patients who receive lamivudine prophylaxis. It is thus recommended that all hepatitis B surface antigen carriers receive lamivudine, or a comparable anti-viral agent, as prophylaxis from the initiation of chemotherapy until at least 1 year following its completion.
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Authors | H E Kohrt, D L Ouyang, E B Keeffe |
Journal | Alimentary pharmacology & therapeutics
(Aliment Pharmacol Ther)
Vol. 24
Issue 7
Pg. 1003-16
(Oct 01 2006)
ISSN: 0269-2813 [Print] England |
PMID | 16984494
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Antineoplastic Agents
- Antiviral Agents
- Reverse Transcriptase Inhibitors
- Lamivudine
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Topics |
- Antineoplastic Agents
(adverse effects)
- Antiviral Agents
(therapeutic use)
- Hepatitis B, Chronic
(prevention & control, virology)
- Humans
- Lamivudine
(therapeutic use)
- Prospective Studies
- Randomized Controlled Trials as Topic
- Reverse Transcriptase Inhibitors
(therapeutic use)
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