title: Benefits associated with antiviral treatment in kidney allograft recipients with chronic hepatitis B virus infection.
abstract: OBJECTIVE
  Hepatitis B virus (HBV) infection is more frequent in kidney recipients than in the general population with a higher rate of liver-related morbidity and mortality. We evaluated the benefit associated with HBV viral suppression by nucleos(t)ide analogues treatment in HBV-infected kidney recipients.
  
  
  METHODS
  This retrospective study included 42 HBsAg-positive kidney recipients, 33 males, 9 females, median age 54 years, followed up during a mean of 15.4±11.8 years after kidney transplantation. Mean treatment duration by single or combined nucleos(t)ide analogues was 6.8±4.3 years. Fibrosis, before treatment, according to Metavir score was: F4 for 6 patients, F3 for 10, F2 for 6, and F0-F1 for 20 patients. The primary end point, the patient survival, was defined as patient death or liver transplantation, the secondary end point was graft survival.
  
  
  RESULTS
  HBV DNA at the last evaluation was undetectable (<12 IU/ml) in 92.8% of patients. During the follow-up, 8 patients died (17.7%), death being related to hepatocellular carcinoma in 4 (9.5%), including 1 patient with baseline mild fibrosis, and to extrahepatic causes in 4. This mortality rate is strikingly lower than that previously reported in HBV-infected kidney recipients before oral antiviral therapies. Graft survival seems to be improved when compared to the former series.
  
  
  CONCLUSIONS
  Suppression of HBV replication associated with nucleo(s)tide analogues treatment improves the survival of HBV-infected kidney recipients. Viral suppression does not exclude regular follow-up given the risk of occurrence of hepatocellular carcinoma even in non-cirrhotic patients.
authors.affiliation: Université Paris Descartes, Unité d'Hépatologie, Assistance Publique Hôpitaux de Paris, Hôpital Cochin et Inserm U-1016, France. sf_cosconea@yahoo.co.uk
authors.forename: Simona
authors.initials: S
authors.lastname: Cosconea
authors.forename: Hélène
authors.initials: H
authors.lastname: Fontaine
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Méritet
authors.forename: Marion
authors.initials: M
authors.lastname: Corouge
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.forename: Anais
authors.initials: A
authors.lastname: Vallet-Pichard
authors.forename: Vincent
authors.initials: V
authors.lastname: Mallet
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality; D004279:DNA, Viral / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D008103:Liver Cirrhosis / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000401:mortality / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D004279:DNA, Viral