title: Long-term add-on therapy with adefovir in lamivudine-resistant kidney graft recipients with chronic hepatitis B.
abstract: BACKGROUND
  To assess the long-term effectiveness and safety of adefovir (ADV) plus lamivudine (LMV) in LMV-resistant (R) kidney transplants with chronic hepatitis B, 11 such patients were treated with add-on ADV.
  
  
  METHODS
  Serum alanine aminotransferase, renal function and serum hepatitis B virus (HBV) DNA levels were assessed every 3 months; ADV mutations were searched for by INNO-LiPA HBV DR v2 assay.
  
  
  RESULTS
  During 36 months (12-48), nine patients cleared serum HBV DNA with a 3-year cumulative virological response rate of 88%, without the emergence of ADV mutations. ADV dose was reduced in six patients (55%) showing a decline of creatinine clearance, in the absence of proximal tubulopathy.
  
  
  CONCLUSIONS
  In LMV-R kidney graft recipients, long-term add-on therapy with ADV is efficacious and safe with timely adaptation of ADV dose.
authors.affiliation: A. M. and A. Migliavacca Center for Liver Disease, 1° Division of Gastroenterology, Department of Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy. pietro.lampertico@unimi.it
authors.forename: Pietro
authors.initials: P
authors.lastname: Lampertico
authors.forename: Mauro
authors.initials: M
authors.lastname: Viganò
authors.forename: Floriana
authors.initials: F
authors.lastname: Facchetti
authors.forename: Federica
authors.initials: F
authors.lastname: Invernizzi
authors.forename: Adriana
authors.initials: A
authors.lastname: Aroldi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Lunghi
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Messa
authors.forename: Massimo
authors.initials: M
authors.lastname: Colombo
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000235:genetics; D024882:Drug Resistance, Viral / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D016030:Kidney Transplantation; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D019259:Lamivudine; D000225:Adenine; C106812:adefovir dipivoxil