Adefovir Dipivoxil Therapy in Liver Transplant Recipients With Lamivudine-Resistant Hepatitis B Virus

Echanojáuregui, A. Herreros de Tejada; Planas, J.M. Moreno; González, Eduardo Rubio; Azorin, F.; Monclús, Javier López; Negro, J. Revilla; Poza, José Luis Lucena de la; Turrión, Víctor Sánchez; Peinado, C. Barrios; Cuervas-Mons, Valentín

doi:10.1016/j.transproceed.2005.02.031

Cited by 19 publications

(11 citation statements)

References 6 publications

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“…In our institution, LT recipients diagnosed with or suspected of HBV recurrence are immediately started on concurrent treatment with adefovir and entecavir as a first‐line rescue regimen,26‐30 with dual therapy continued until definite improvements in biochemical and virologic parameters are evident. We had previously attempted to treat acute exacerbation with a triple therapy regimen, consisting of adefovir, entecavir, and lamivudine or clevudine, but this regimen was abandoned after entecavir resistance developed.…”

Section: Discussionmentioning

confidence: 99%

Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on

et al. 2011

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A considerable proportion of liver transplantation recipients who receive hepatitis B immunoglobulin (HBIG) monotherapy for hepatitis B virus (HBV) prophylaxis develop resistance to HBIG. We retrospectively assessed the efficacy of HBV prophylaxis in 1524 patients who received primary high-dose HBIG monotherapy (n ¼ 1463) or with a preemptive antiviral add-on as secondary combination therapy (n ¼ 61). At a median follow-up time of 57 months, 106 (7.3%) patients receiving HBIG monotherapy experienced HBV recurrence, with a 10-year HBV recurrence rate of 9.8%, compared to none of the patients receiving preemptive combination therapy (P ¼ 0.047). Thirteen patients (12.3%) with HBV recurrence failed antiviral therapy, leading to death or retransplantation. Response rates to rescue therapy before and after use of adefovir/entecavir were 44.4% and 91.8%, respectively. Acute exacerbation was not associated with treatment failure, but required prolonged treatment. Of 84 surviving patients with HBV recurrence, 44 (52.4%) showed no evidence of blood HBV DNA. The Gly145Arg mutation was found in 11 of 15 (73.3%) patients, whereas 25 of 71 (35.2%), 2 of 29 (6.9%), and 4 of 8 (50%) patients were resistant to lamivudine, adefovir, and entecavir, respectively. In conclusion, our finding of a 10-year HBV recurrence rate of 9.8% in patients receiving high-dose HBIG monotherapy indicates that this treatment is effective but requires complementary measures. Strict surveillance following HBIG monotherapy is necessary to enhance responses to rescue antiviral therapy. Preemptive conversion to combination therapy has a complementary role in prophylaxis with primary high-dose HBIG monotherapy, especially for patients at high risk of HBV recurrence. Liver Transpl 17: 456-465, 2011. V C 2011 AASLD. Received September 7, 2010 accepted November 11, 2010. Prevention of hepatitis B virus (HBV) recurrence is essential after liver transplantation (LT) in patients infected with HBV. Individual institution-based protocols for posttransplantation HBV prophylaxis involve treatment with hepatitis B immunoglobulin (HBIG) and/or antiviral agents.1-4 Although several potent antiviral agents are available to treat HBV, drugresistant strains frequently emerge. HBIG therapy, Abbreviations: Anti-HBs, antibody to hepatitis B surface antigen; anti-HBc, immunoglobulin G antibody to hepatitis B core

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Section: Discussionmentioning

confidence: 99%

Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on

et al. 2011

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“…Switching to adefovir dipivoxil with or without continued lamivudine are alternative options. Long-term add-on therapy with adefovir has been found to be consistently effective in several independent studies [39,40,103], even those involving HBeAg-negative cirrhotics [53] and patients who have been imunosuppressed for organ transplant or by co-infection with HIV-1 [52,[104][105][106][107]. Switching to entecavir (at a daily dose of 1 mg rather than 0.5 mg recommended for treatment-naive patients) after lamivudine failure has been shown to be effective in clinical trials [108], but this strategy may encourage development of resistance to entecavir [54].…”

Section: Management Of Pre-existing Nrti Resistancementioning

confidence: 99%

HBV drug resistance: Mechanisms, detection and interpretation

Shaw

Bartholomeusz

Locarnini

2006

Journal of Hepatology

213

178

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“…Adefovir diphosphate inhibits viral polymerases and causes DNA chain termination. 8 Study of Li et al 9 showed that the adefovir dipivoxil was effective and safe for the treatment of HBV-GN. The titer of HBV-DNA in 76 patients was reduced significantly, and the replication of the HBV-DNA was inhibited well.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of adefovir dipivoxil combined with a corticosteroid in 38 cases of nephrotic syndrome induced by hepatitis B virus-associated glomerulonephritis

Li¹,

Yuan²,

Qiu³

et al. 2014

Renal Failure

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Objective: To investigate the treatment efficacy of adefovir dipivoxil combined with a corticosteroid on hepatitis B virus-associated glomerulonephritis (HBV-GN). Methods: A total of 38 patients with nephrotic syndrome induced by HBV-GN were treated for 36 weeks between 2010 and 2012. Results: The efficacy analysis showed that 11 patients achieved complete remission and 17 patients achieved partial remission, and the effective remission rate was 73.7%. In addition, 10 patients achieved no remission. Conclusions: Adefovir dipivoxil combined with corticosteroids has a certain efficacy on the HBV-GN and displays few adverse reactions. A large sample, randomized double-blind controlled study and long-term follow-up are needed to verify the efficacy of adefovir dipivoxil combined with corticosteroids.

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Adefovir Dipivoxil Therapy in Liver Transplant Recipients With Lamivudine-Resistant Hepatitis B Virus

Cited by 19 publications

References 6 publications

Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on

Posttransplantation prophylaxis with primary high-dose hepatitis B immunoglobulin monotherapy and complementary preemptive antiviral add-on

HBV drug resistance: Mechanisms, detection and interpretation

Efficacy of adefovir dipivoxil combined with a corticosteroid in 38 cases of nephrotic syndrome induced by hepatitis B virus-associated glomerulonephritis

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