Hepatitis B immunoglobulin in combination with lamivudine for prevention of hepatitis B virus reactivation in children undergoing bone marrow transplantation

Pediatr Transplant. 2006 Dec;10(8):966-9. doi: 10.1111/j.1399-3046.2006.00570.x.

Abstract

There is little information in literature about the use of hepatitis B immunoglobulin (HBIg) in recipients of bone marrow transplantation (BMT). Here, we report two children who received IV HBIg (Hepatect-CP) and lamivudine treatment during BMT course for either patient or donor hepatitis B virus (HBV) viremia. A four-year-old girl underwent a fully human leukocyte antigen-matched allogeneic BMT for thalassemia major from her mother positive for hepatitis B surface antigen (HBsAg). A 12-yr-old boy with chronic myeloid leukemia, positive for HBsAg and HBV-DNA received a fully HLA-matched allogeneic BMT from his sister in the first chronic phase of the disease. HBIg was successfully used in both cases to prevent HBV reactivation of the recipients. The results of our observations are encouraging and we suggest that HBIg in combination with lamivudine may be used in such cases especially in post-transplant early period to prevent HBV reactivation.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow Transplantation* / immunology
  • Bone Marrow Transplantation* / methods
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Female
  • Hepatitis B / prevention & control*
  • Hepatitis B Surface Antigens / blood
  • Hepatitis B virus / drug effects
  • Hepatitis B virus / physiology*
  • Humans
  • Immunoglobulins / therapeutic use*
  • Immunologic Factors / therapeutic use*
  • Lamivudine / therapeutic use*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery
  • Male
  • Middle Aged
  • Reverse Transcriptase Inhibitors / therapeutic use*
  • Secondary Prevention
  • Transplantation, Homologous
  • Virus Activation / drug effects*
  • beta-Thalassemia / surgery

Substances

  • Hepatitis B Surface Antigens
  • Immunoglobulins
  • Immunologic Factors
  • Reverse Transcriptase Inhibitors
  • Lamivudine
  • hepatitis B hyperimmune globulin