BACKGROUND: Chronic hepatitis B virus infection is one of the major causes of liver cirrhosis worldwide, especially in Asia. Liver transplantation for the end-stage liver disease with hepatitis B virus(HBV) is commonly complicated by the recurrence of HBV. The present study was designed to evaluate lamivudine in the prevention and treatment of recurrent HBV after liver transplantation.
METHODS: Seventeen patients with HBV-related liver disease in a total of 41 patients have received liver transplantation at our hospital since 2001. All the patients were HBV positive before transplantation, 5 of them had acute liver failure. Artificial liver was used in 4 patients with acute liver failure. All of the patients received lamivudine at a dose of 100 mg/d after liver transplantation. Lamivudine and HBIg therapy were given to 3 patients.
RESULTS:  Liver transplantation was successfully performed in all 17 patients. Three patients died of complications 3-6 months after the transplantation. One patient withdraw from lamivudine therapy and died of liver failure at 14 months after the transplantation. Thirteen patients were  followed up from 6 to 18 months. Two viremic patients had HBV recurrence shortly after the transplantation. Two viremic patients who had received HBIg and lamivudine after the transplantation had no evidence of HBV recurrence.
CONCLUSIONS: Lamivudine therapy is effective in preventing HBV recurrence after liver transplantation. The recurrence of HBV is closely related to HBV DNA status before liver transplantation.