Entecavir therapy in a hepatitis B-related decompensated cirrhotic patient.
A 58-year-old Arab-American male with HBeAg-negative chronic hepatitis B (HBV), presented with decompensated cirrhosis and a high HBV DNA level. He responded to entecavir with a significant reduction in serum HBV DNA level after 15 weeks of therapy with entecavir. However, he developed a progressive rise in prothrombin time/international normalized ratio (PT/INR) and bilirubin and underwent liver transplantation after receiving 22 weeks of entecavir therapy. Furthermore, with the continued use of combination entecavir and hepatitis B immunoglobulins (HBIG), he showed improvement in his clinical status with a nondetectable serum HBV DNA level 12 weeks after transplantation. He continued to maintain nondetectable serum HBV DNA 2 years following transplantation. To the best of our knowledge, this is the first reported case of a patient with decompensated chronic HBV who responded to entecavir both before and after transplantation without showing any evidence of recurrent HBV. Larger clinical trials are recommended to compare both short-term and long-term efficacy using entecavir among nucleoside-naïve decompensated chronic HBV patients before and after liver transplantation.
Muneer
Badar
B
Center for Liver Diseases, Section of Gastroenterology, University of Chicago, Chicago, IL 60637-1463, USA.
Testa
Giuliano
G
Millis
J M
JM
Mohanty
Smruti R
SR
D000998:Antiviral Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004279:DNA, Viral / Q000097:blood / Q000187:drug effects; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D006515:Hepatitis B virus / Q000187:drug effects; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents; D004279:DNA, Viral; C413685:entecavir; D006147:Guanine