Entecavir therapy for adefovir-resistant hepatitis B virus infection in kidney and liver allograft recipients.
The aim of our study was to assess the efficacy and safety of entecavir in kidney- and liver-transplant recipients with chronic hepatitis B virus (HBV) infection. Ten male transplant patients with chronic HBV infection (eight kidney- and two liver-transplant patients), who have become adefovir (n=9) or lamivudine-resistant (n=1) were given entecavir at 0.5 to 1 mg/d. All patients were HBs Ag positive: six were HBe Ag(-)/HBe Ab(+), and four were HBe Ag(+)/HBe Ab(-). After a median follow-up of 16.5 months, entecavir therapy was associated with a significant decrease in HBV DNA viral load, that is, 3.86 (2.71-6.46) log10 copies/mL at baseline down to 2.94 (2.15-4) log10 copies/mL at last follow-up (P=0.004). Rate of HBV DNA clearance was 50% in both HBeAg(+) and HBeAg(-) patients. There were no significant changes in renal function or hematological parameters. This study demonstrates that entecavir therapy is safe and efficient in HBV(+) organ-transplant patients.
Kamar
Nassim
N
Nephrology, Dialysis, and Multiorgan Transplant Unit, University Hospital, CHU Rangueil, 31059 Toulouse Cédex 9, France.
Milioto
Olivier
O
Alric
Laurent
L
El Kahwaji
Labib
L
Cointault
Olivier
O
Lavayssière
Laurence
L
Sauné
Karine
K
Izopet
Jacques
J
Rostaing
Lionel
L
D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006509:Hepatitis B / Q000188:drug therapy* / Q000601:surgery*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000187:drug effects / Q000276:immunology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D010865:Pilot Projects; D011517:Prothrombin Time
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D063065:Organophosphonates; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000225:Adenine