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Response to adefovir or entecavir in renal allograft recipients with hepatitic flare due to lamivudine‐resistant hepatitis B
Author(s) -
Tse Kai Chung,
Yap Desmond Y. H.,
Tang Colin S. O.,
Yung Susan,
Chan Tak Mao
Publication year - 2010
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01090.x
Subject(s) - adefovir , entecavir , medicine , lamivudine , gastroenterology , creatinine , hepatitis b virus , renal function , hepatitis b , virology , virus
Tse KC, Yap DYH, Tang CSO, Yung S, Chan TM. Response to adefovir or entecavir in renal allograft recipients with hepatitic flare due to lamivudine‐resistant hepatitis B.
Clin Transplant 2009 DOI: 10.1111/j.1399‐0012.2009.01090.x
© 2009 John Wiley & Sons A/S. Abstract: We studied the effects of adefovir or entecavir in six kidney transplant recipients (mean age 45.7 ± 7.8 yr) who developed hepatitic flare due to lamivudine‐resistant hepatitis B virus (HBV) infection, with 18 months of follow‐up. All patients had elevated alanine aminotransferase (ALT) levels and HBV DNA >10 5 copies/mL (median 2.15 × 10 8 copies/mL) at baseline. Serum creatinine and creatinine clearance levels were 137.8 ± 59.7 μmol/L and 62.6 ± 18.7 mL/min, respectively. Four patients were treated with adefovir and two with entecavir. Median HBV DNA decreased to 1.99 × 10 5 copies/mL (p = 0.028) after six months, 1.5 × 10 4 copies/mL (p = 0.043) after 12 months, and 7.35 × 10 4 copies/mL (p = 0.068) after 18 months of treatment. There was a corresponding improvement in ALT (34.5 ± 19.1 U/L after 18 months, p = 0.029 compared with baseline). The rate of HBV DNA suppression was variable, and three patients took over six months for the viral load to decrease to <10 5 copies/mL. After 18 months, HBV DNA was <10 5 copies/mL in four patients and <10 2 copies/mL in one patient. Treatment was well‐tolerated and renal function remained stable. We conclude that both adefovir and entecavir are effective in the treatment of lamivudine‐resistant HBV in renal allograft recpients, and the reduction of HBV DNA to <10 5 copies/mL could be slow.