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Efficacy and safety of tenofovir, entecavir, and telbivudine for chronic hepatitis B in heart transplant recipients
Author(s) -
DuranteMangoni E.,
Vitrone M.,
Parrella A.,
Andini R.,
Iossa D.,
Ragone E.,
Falco E.,
Maiello C.,
Utili R.,
Zampino R.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12525
Subject(s) - medicine , entecavir , telbivudine , hepatitis b , gastroenterology , hepatocellular carcinoma , tolerability , hepatitis b virus , adverse effect , lamivudine , immunology , virus
Background Treatment of chronic hepatitis B ( CHB ) with polymerase inhibitors is key to prevent disease flares and progression toward advanced liver disease. Efficacy and tolerability of newer agents has been reported anecdotally in transplant recipients. Methods In this prospective, observational study, we assessed outcomes of therapy with tenofovir ( TDF ), entecavir ( ETV ), and telbivudine (LdT) in 13 heart transplant recipients ( HTR ) with CHB . Results Most patients were hepatitis B e antigen negative, had low baseline hepatitis B virus ( HBV ) DNA , and normal aminotransferases. Liver biopsy showed a median fibrosis score of 1.5 (range 0–4). Glomerular filtration rate ( GFR ) was <50 mL/min in 7 patients (54%). Two patients were started on de novo ETV before transplant. Eleven previously treated patients were switched to TDF ( n = 9) or LdT ( n = 2). Median treatment duration was 33 months (range 1–71). HBV DNA remained suppressed in 6 patients and became undetectable in 5. Aminotransferases went down to the normal range in all patients, with a single flare in 1 patient. One patient lost hepatitis B surface antigen. No cases occurred of hepatic decompensation, hepatocellular carcinoma, or liver‐related death. The GFR remained largely stable, and no cases of TDF ‐related hyper‐phosphaturia were observed. Conclusions This study indicates that newer antivirals are effective and safe in HTR with CHB .