title: Study on the efficacy and safety of adefovir dipivoxil treatment in post-liver transplant patients with hepatitis B virus infection and lamivudine-resistant hepatitis B virus.
abstract: Hepatitis B virus (HBV) recurrence and de novo HBV infection are frequent events in liver transplantation recipients. Treatment with lamivudine is initially efficient in both infections but the incidence of lamivudine-resistant HBV emergence increases over time. Adefovir appears to be promising in post-liver transplantation patients with recurrent HBV infection and lamivudine-resistant HBV. This study analyzed adefovir treatment in 42 post-liver transplantation patients who developed recurrent HBV or de novo HBV infection with lamivudine-resistant HBV (54.8% HCV-coinfected). Patients received 10 mg of oral adefovir once daily for a mean period of time of 21.5 months (range from 12 to 31 months). In 62.9% of patients, ALT levels decreased significantly. Serum HBV-DNA was undetectable in 64% of the cases. Twenty percent of patients lost HBeAg marker and 13.3% of them developed anti-HBe. In 9.5% of recipients, HBsAg became negative. There was no significant change in serum creatinine levels. In only one patient was worsening of the renal function detected, making dose adjustment necessary. No other side effects were reported. Our results confirm the efficacy and safety of adefovir treatment in post-liver transplantation patients with lamivudine-resistant HBV, neither were adefovir-resistant mutations identified in patients after 21 months of therapy, nor were there adverse events, especially renal toxicity.
authors.affiliation: Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Bárcena
authors.forename: S
authors.initials: S
authors.lastname: Del Campo
authors.forename: G
authors.initials: G
authors.lastname: Moraleda
authors.forename: T
authors.initials: T
authors.lastname: Casanovas
authors.forename: M
authors.initials: M
authors.lastname: Prieto
authors.forename: M
authors.initials: M
authors.lastname: Buti
authors.forename: J M
authors.initials: JM
authors.lastname: Moreno
authors.forename: V
authors.initials: V
authors.lastname: Cuervas
authors.forename: E
authors.initials: E
authors.lastname: Fraga
authors.forename: M
authors.initials: M
authors.lastname: De la Mata
authors.forename: A
authors.initials: A
authors.lastname: Otero
authors.forename: M
authors.initials: M
authors.lastname: Delgado
authors.forename: C
authors.initials: C
authors.lastname: Loinaz
authors.forename: C
authors.initials: C
authors.lastname: Barrios
authors.forename: M L G
authors.initials: ML
authors.lastname: Dieguez
authors.forename: A
authors.initials: A
authors.lastname: Mas
authors.forename: J M
authors.initials: JM
authors.lastname: Sousa
authors.forename: J I
authors.initials: JI
authors.lastname: Herrero
authors.forename: R
authors.initials: R
authors.lastname: Muñoz
authors.forename: J F
authors.initials: JF
authors.lastname: Avilés
authors.forename: A
authors.initials: A
authors.lastname: Gonzalez
authors.forename: M
authors.initials: M
authors.lastname: Rueda
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000410:Alanine Transaminase / Q000097:blood; D024882:Drug Resistance, Viral; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety
chemical_list: D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D063065:Organophosphonates; D019259:Lamivudine; D000410:Alanine Transaminase; D000225:Adenine; C106812:adefovir dipivoxil