Hepatitis B viral reactivation in patients undergoing chemotherapy is associated with significant morbidity and mortality.
Lamivudine has been suggested to be useful as a prophylaxis for Hepatitis B viral reactivation.
However, its impact on overall survival and Hepatitis B viral reactivation-related liver disease survival is unclear.
|Those given lamivudine prophylaxis had a 87% decrease in Hep B viral reactivation|
Dr Lenna Martyak and colleagues from California, USA determined the effect of lamivudine prophylaxis on the rate of Hepatitis B viral reactivation.
The research team also determined the overall survival and Hepatitis B viral reactivation-related survival in patients with Hepatitis B viral undergoing chemotherapy.
A comprehensive search of MEDLINE, Cochrane Collaboration Database, reference lists, and abstracts from national meetings was undertaken.
The team performed statistical analysis using revman.
The researchers found that 11 studies met the defined inclusion criteria, and included these in the analysis.
Lamivudine prophylaxis was received by 220 patients, and 400 did not receive prophylaxis.
The team found that patients given lamivudine prophylaxis had a 87% decrease in Hepatitis B viral reactivation.
The number needed to treat to prevent 1 reactivation was 3.
The team found that the lamivudine prophylaxis group was also associated with a 70% reduction in reactivation-related mortality compared with controls.
There was a reduction in treatment delays, and premature termination of chemotherapy in the lamivudine prophylaxis arm.
The team found no significant heterogeneity in the comparisons.
Dr Martyaks' team concluded, "Lamivudine prophylaxis during chemotherapy is effective in reducing the rate of Hepatitis B viral reactivation, and reactivation-related liver mortality."
"Patients with lamivudine prophylaxis had less chemotherapy treatment delays, and premature termination of their chemotherapy."
"Few patients need to be treated to prevent reactivation."
"Patients with Hepatitis B viral undergoing chemotherapy should be started on lamivudine prophylaxis."