Dr Katz and colleagues from Israel assessed the effects of prophylactic lamivudine on reactivation and mortality following immunosuppressive therapy in Hepatitis B surface antigen-positive patients.
|11 patients need to be treated to prevent 1 death|
|Journal of Viral Hepatitis|
The team performed a systematic review and meta-analysis of randomized and nonrandomized prospective controlled trials and retrospective comparative case series.
The team used the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and LILACS.
The team's primary outcomes were virological reactivation, clinical reactivation and mortality.
Secondary outcomes included Hepatitis B virus-related mortality, liver histology, discontinuation or disruption of immunosuppressive therapy, lamivudine-resistant Hepatitis B virus strains and adverse events.
The team identified a total of 21 studies, 2 of which were randomized controlled trials.
The research team found that clinical and virological reactivation were significantly reduced in the lamivudine group.
All-cause mortality was significantly reduced in the lamivudine group, which translates to only 11 patients who need to be treated to prevent 1 death.
The researchers found that lamivudine significantly reduced Hepatitis B virus-related mortality, and discontinuations or disruptions of the immunosuppressive treatment.
No adverse effects of lamivudine were recorded, and resistance to lamivudine occurred in low rates.
Dr Katz's team concluded, "We demonstrated a clear benefit of lamivudine in terms of clinical and virological Hepatitis B virus reactivation, overall mortality, Hepatitis B virus-related mortality and interruptions or discontinuations in the immunosuppressive treatment."
" Lamivudine should be administered prophylactically to Hepatitis B surface antigen-positive patients who are about to receive immunosuppressive therapy."