Conversion of recurrent delta-positive hepatitis B infection to seronegativity with famciclovir after liver transplantation.
BACKGROUND
Recurrent hepatitis B infection after liver transplantation is associated with poor graft and patient survival. Famciclovir is a nucleoside with virostatic action in hepatitis B infection. We report the case of a 51-year-old patient who developed recurrent delta-positive hepatitis B infection after liver transplantation. After famciclovir treatment, he became seronegative for hepatitis B early and hepatitis B surface antigens and developed protective anti-hepatitis B surface antibody titers.


METHODS
After recurrent hepatitis B was confirmed, treatment with famciclovir was initiated.


RESULTS
Eighteen days after starting famciclovir, the patient became seronegative for hepatitis B early antigen and delta antigen, and hepatitis B virus DNA was no longer detectable in serum. Three months later, the patient became hepatitis B surface antigen negative and remains well 16 months later with increasing anti-hepatitis B surface levels.


CONCLUSIONS
Antiviral treatment with famciclovir may be useful in treatment of delta-positive hepatitis B infection following liver transplantation. Further evaluation of famciclovir in treatment and prevention of hepatitis B in these patients is warranted.
Klein
M
M
Department of Surgery, Friedrich-Schiller University of Jena, Germany.
Geoghegan
J
J
Schmidt
K
K
Böckler
D
D
Korn
K
K
Wittekind
C
C
Scheele
J
J
D015075:2-Aminopurine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D000077595:Famciclovir; D006509:Hepatitis B / Q000188:drug therapy*; D006515:Hepatitis B virus / Q000276:immunology; D003699:Hepatitis D / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D003698:Hepatitis Delta Virus / Q000276:immunology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D000956:Antigens, Viral; D000998:Antiviral Agents; D015075:2-Aminopurine; D000077595:Famciclovir