Long Term Renal Allograft Survival with Active Hepatitis B Infection in a Sibling-To-Sibling Transplant Recipient: a Case Report
Here we report on a 69-year old man with a well-functioning kidney transplant 25 years post-transplant, with active hepatitis B viral replication. The recipient was not inducted and received oral prednisolone, azathioprine and cyclosporine as maintenance therapy. He was detected to be hepatitis B surface antigen (HBsAg) positive on routine screening in the early period following transplantation and his donor younger brother was also detected to be HbsAg positive. Recipient could not afford anti-viral drugs initially. Hepatitis B viral load was detected to be 2.2 × 1010 viral copies/ml 21 years after transplantation with good allograft function. He took lamivudine 100 mg once a day for the next 6 months, and then discontinued and was followed up with yearly with liver function tests, alpha-feto protein (AFP), ultrasound examination of the abdomen with a specific focus on liver. His current allograft function showed a serum creatinine 1.1 mg/dl, blood urea 20.6 mg/dl and his urine examination are normal. He is well and leading a normal life and his current viral load is >107 copies / ml.