A Comparison of Lamivudine and Entecavir for the Prophylaxis of Hepatitis B Virus Reactivation in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation: A Single Institutional Experience

Backgroud:

To compare the efficacy of lamivudine and entecavir in the prevention of hepatitis B virus (HBV) reactivation in HBsAg-positive patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Method:

A total of 216 consecutive HBV surface antigen (HBsAg) positive patients undergoing allo-HSCT at our institute between March 2008 and March 2014 were enrolled in this retrospective investigation.

Results:

Of the 216 patients, 119 received lamivudine and 97 received entecavir to prevent HBV reactivation. The cumulative rate of HBV reactivation at 24 ^th, 48 ^th, and 96 ^th post-transplantation were 7.0% and 0.0%, 15.0% and 1.0%, and 24.0% and 2.0% in lamivudine and entecavir groups, respectively. The cumulative rate of severe hepatitis attributable to HBV reactivation were 5.9% and 0.0% (p = 0.01) in lamivudine and entecavir groups at week 96 post-transplantation, respectively. On the 12^th, 24^th, and 48^th weeks of anti-viral therapythe average serum HBV-DNA levels reduction in entecavir group were greater than in the lamivudine  Drug-resistant mutation sites were detected in 25 (21.0%) patients in the lamivudine group and in one patient (1.0%) in the entecavir group.

Conclusion:

Our data indicates that entecavir might reduce the incidence of HBV reactivation and severe HBV reactivation hepatitis in HBsAg-positive allo-HSCT recipients compared to lamivudine.