title: [Post-transplant prophylaxis of the recurrence of lamivudine-resistant YMDD mutant hepatitis B virus in liver recipients].
abstract: OBJECTIVE
  To evaluate the prophylactic efficacy of adefovir dipivoxil (ADV) for post-transplant recurrence of hepatitis B virus (HBV) with lamivudine-resistant YMDD mutation in liver recipients.
  
  
  METHODS
  From March 2004 to May 2006, 20 patients with chronic hepatitis B associated with YMDD mutant HBV prior to liver transplantation received treatment with ADV and additional intramuscular hepatitis B immunoglobulin (HBIG) for prevention of post-transplant graft reinfection. The liver function, serum HBsAg, anti-HBs (HBIG), HBeAg, anti-HBc, anti-HBe, HBV DNA and creatinine were examined in all the patients before and after the transplantation.
  
  
  RESULTS
  The median follow-up duration of these patients after the transplantation was 33.5 months. Nineteen patients survived and one patient died of recurrent hepatocellular carcinoma. There was significant difference in YMDD mutation rate between the patients with HBV-DNA over 10(6) copies/ml and those with HBV-DNA less than 10(6) copies/ml (12.4% vs 2.5%, P < 0.05). HBV-DNA was undetectable at 4 weeks after the transplantation in 95.0% of the patients (19/20) and at 6 months in one case. No recurrence of hepatitis B was detected by long-term regular testing of HBsAg, HBeAg and HBV-DNA. Serum creatinine increased in 1 case 1 year after the use of ADV.
  
  
  CONCLUSIONS
  ADV offers protection against recurrence of HBV with YMDD mutation after liver transplantation with only mild nephrotoxicity, but renal function monitoring during the use of ADV is still necessary.
authors.affiliation: Liver Transplantation Center, Third Affiliated Hospital/Institute of Organ Transplantation, Sun Yat-sen University, Guangzhou 510630, China. yysysu@163.com
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Hui-min
authors.initials: HM
authors.lastname: Yi
authors.forename: Min-qiang
authors.initials: MQ
authors.lastname: Lu
authors.forename: Chang-jie
authors.initials: CJ
authors.lastname: Cai
authors.forename: Xi
authors.initials: X
authors.lastname: Li
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
authors.forename: Chi
authors.initials: C
authors.lastname: Xu
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.forename: Gen-shu
authors.initials: GS
authors.lastname: Wang
authors.forename: Shu-hong
authors.initials: SH
authors.lastname: Yi
authors.forename: Jun-feng
authors.initials: JF
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Gui-hua
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D020816:Amino Acid Motifs; D000998:Antiviral Agents / Q000627:therapeutic use; D004259:DNA-Directed DNA Polymerase / Q000235:genetics; D024882:Drug Resistance, Viral; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D012008:Recurrence
chemical_list: D000998:Antiviral Agents; D019259:Lamivudine; D004259:DNA-Directed DNA Polymerase