Efficacy and Safety of Entecavir and/or Tenofovir for Prophylaxis and Treatment of Hepatitis B Recurrence Post–Liver Transplant

Jiménez‐Pérez, Miguel; Sáez-Gómez, A.B.; Poce, L. Mongil; Lozano-Rey, J.M.; Cruz-Lombardo, J. de la; Rodrigo-López, J.M.

doi:10.1016/j.transproceed.2010.05.127

Cited by 62 publications

(63 citation statements)

References 6 publications

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“…ComposVarela/2011 [38] Cai/2012 [147] Di Costanzo/2013 [22] Gao [103] Hwang/2011 [97] Hwang/2008 [98] Hu/2012 [148] Ishigami/2011 [149] Kim/2013 [104] Jiménez-Pérez/2010 [93] McGonigal/2013 [101] Perrella/2012 [56] Perrakis/2013 [100] Perrillo/2013 [150] Roche/2010 [28] Tanaka/2012 [102] Teperman/2010 [57] Ueda/2013 [151] Varghese/2014 [105] Xie/2010 [95] Xi/2009 [100] Yasunaka/2011 [46] antiviral NAs and further studies needed to test their effectiveness as part of combination therapy with HBIG and/or montherapy strategies [78][79][80] .…”

Section: Authormentioning

confidence: 99%

“…During the new NA era for the prophylaxis against HBV recurrence following LT, many centers have been using these drugs only in the case of drug resistance following lamivudine administration as either add-on or switching approaches in combination with HBIg as rescue therapy [13,37,45,49,[92][93][94][95][96][97] (Table 4). ADV has been at the top of this list for only cases who acquired HBV reinfection due to LAMresistance.…”

Section: Rescue Therapymentioning

confidence: 99%

“…Longer follow up study showed a 3 year sustained survival of 87% in these patients group [87] . Also, entecavir showed promising results for these patients with no cases of recurrence [38,88,93,98] . However, despite entecavir is an ideal antiviral agent in nucleoside-naïve patients for its potent antiviral effects, low rate of drug resistance, and lack of nephrotoxicity, as entecavir-resistant mutations are more likely to be selected in the presence of lamivudine-resistant mutations, some authors have not recommended this drug in patients with lamivudine-resistant HBV [10] .…”

Section: Rescue Therapymentioning

confidence: 99%

“…However, despite entecavir is an ideal antiviral agent in nucleoside-naïve patients for its potent antiviral effects, low rate of drug resistance, and lack of nephrotoxicity, as entecavir-resistant mutations are more likely to be selected in the presence of lamivudine-resistant mutations, some authors have not recommended this drug in patients with lamivudine-resistant HBV [10] . Other new NA agents like Emtricitabine (FTC), Tenofovir (TDF); Famciclovir (FAM) [13,28,38,93] (Table 4) showed to be effective for lamivudine-resistant variants following liver transplantation. However, the sample sizes in these studies on the effectiveness of new NA agents were too small to make a definite conclusion.…”

Section: Rescue Therapymentioning

confidence: 99%

“…[92] Hwang/2011 [97] Neff/2004 [13] Jiménez-Pérez/2010 [93] Perrakis are antiviral agents of choice for the treatment of HBV. However, due to lack of data and despite some few studies that showed their effectiveness when they included in the prophylactic regimen [38,93,96] (Table 3), combination of NAs without the concomitant use of HBIg is generally not recommended.…”

Section: Conflict Of Interestsmentioning

confidence: 99%

See 4 more Smart Citations

Controversies Regarding the Hepatitis B Immune Globulin Prophylaxis (HBIG) for Liver Transplantation Recipients

Jazayeri

Rizzetto²,

Alavian

2014

Journal of Gastroenterology and Hepatology Research

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Section: Authormentioning

confidence: 99%

Section: Rescue Therapymentioning

confidence: 99%

Section: Rescue Therapymentioning

confidence: 99%

Section: Rescue Therapymentioning

confidence: 99%

Section: Conflict Of Interestsmentioning

confidence: 99%

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Controversies Regarding the Hepatitis B Immune Globulin Prophylaxis (HBIG) for Liver Transplantation Recipients

Jazayeri

Rizzetto²,

Alavian

2014

Journal of Gastroenterology and Hepatology Research

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Immunoprophylaxis against and prevention of recurrent viral hepatitis after liver transplantation

Laryea

Watt

2012

Liver Transpl

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The reinfection of the hepatic allograft with hepatitis B virus and hepatitis C virus can have important sequelae that result in poor long-term patient and graft survival. Although a response to treatment with antiviral medications can improve these outcomes, not all patients tolerate these medications or experience viral eradication. Avoiding reinfection of the graft is the most effective means of improving the long-term outcomes for these patient populations. This review is focused on the prevention of viral hepatitis reinfection after liver transplantation. Liver Transpl 18:514-523, 2012. V C 2012 AASLD.Received July 2, 2011; accepted February 2, 2012.Although recurrent disease after liver transplantation (LT) can occur with most indications for LT, it is a particular issue with viral hepatitis. The dampening of immune mechanisms by immunosuppression can lead to the recurrence of chronic viral hepatitis from hepatitis B virus (HBV) or hepatitis C virus (HCV) in the graft and can alter its natural history significantly. In fact, an untreated graft reinfection can lead to the rapid progression of fibrosis and early graft loss. The timing and natural history of recurrent viral hepatitis after transplantation can vary according to number of factors, including surgical factors and donor or recipient factors. The treatment of recurrent disease can be more problematic (more so with HCV) in transplant patients versus nontransplant patients because of decreased efficacy and potentially increased side effects. The impact of recurrent disease on overall patient and graft survival can be reduced by the understanding and prevention of recurrent viral hepatitis. This review outlines the progress in prophylaxis focused on reducing the recurrence of HBV and HCV after LT, and it underscores the areas in need of further investigation so that the effects of recurrent disease on posttransplant outcomes can be reduced. HBVThe first experiences with LT for HBV-related disease were marred by high rates of graft failure and patient mortality due to aggressive recurrent disease. These poor outcomes compelled some centers to declare a moratorium on LT for HBV-related disease. Advances in the prevention and treatment of recurrent disease after LT have resulted in overall survival rates now as high as 90% at 5 years, 1 and they have made HBV-related liver disease an acceptable indication for LT worldwide. With appropriate prophylaxis and proper patient adherence, recurrence rates are now consistently less than 10%. Recurrent HBV after transplantation is due to a failure Abbreviations: ADV, adefovir dipivoxil; anti-HBc, antibody to hepatitis B core antigen; anti-HBs, antibody to hepatitis B surface

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Living related liver transplantation for hepatitis B-related liver disease without hepatitis B immune globulin prophylaxis

et al. 2013

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Hepatitis B immune globulin (HBIG) is routinely used in liver transplantation for hepatitis B virus (HBV)-related liver disease. With potent oral antivirals, HBIG may not be required. We conducted a prospective trial to evaluate living related liver transplantation (LRLT) without HBIG. Eighty-nine patients with HBV-related liver disease underwent LRLT between January 2005 and January 2012. All donors were vaccinated with the HBV vaccine. All patients were given oral antivirals for HBV before transplantation. Patients with HBV DNA levels 2000 IU/mL were not given HBIG, and patients with HBV DNA levels > 2000 IU/mL were given HBIG. Recurrence was defined as HBV DNA positivity 6 months after transplantation. Seventy-five of the 89 patients who underwent LRLT for HBV-related liver disease were not given HBIG. Nineteen patients received a combination of lamivudine and adefovir, 42 received entecavir, 12 received tenofovir, and 2 received a combination of entecavir and tenofovir. At the last follow-up (median 5 21 months, range 5 1-83 months), all patients were HBV DNA-negative. Sixty-six patients cleared hepatitis B surface antigen (HBsAg), and 19 patients formed antibody to hepatitis B surface antigen (anti-HBs). The cumulative probabilities of clearing HBsAg were 90% and 92% at 1 and 2 years after transplantation, respectively. Nine patients were HBsAg-positive with undetectable DNA at the last follow-up. The recurrence rate in our series was 8% (6/75). Five of these 6 patients had stopped taking oral antivirals, and 1 had entecavir resistance. All recurrences were salvaged with changes in the oral antivirals. The actuarial probability of survival in this cohort was 73.7% at 83 months. There was no mortality due to HBV recurrence. In conclusion, HBV prophylaxis with oral antivirals and without HBIG is safe and effective in LRLT. A majority of the patients will clear HBsAg, and some will develop anti-HBs antibodies. Patients undergoing transplantation for hepatitis B virus (HBV) cirrhosis require prophylactic antiviral therapy. The risk of HBV reinfection after liver transplantation without prophylaxis is approximately 80%, and the rate is higher for patients with high HBV DNA levels at the time of transplantation. 1,2 The current recommendation for HBV prophylaxis is a combination of a nucleoside/tide analogue and high-dose hepatitis B immune globulin (HBIG) for life. 3 Recently, low-dose HBIG in combination with lamivudine has been shown to be equally efficacious. 4 The combination of HBIG with antivirals (lamivudine and adefovir) has reduced the risk of reinfection to 10% during the first 2 years after transplantation. 5-7 However, with the advent of newer, more effective oral antivirals with lower resistance rates, the role of HBIG in the transplant setting needs to be re-evaluated. 8 There are published data on the transfer of immunity from HBV-immunized donors to recipients of liver transplantation for HBV-related indications. 9,10 Living donor liver transplantation offers a unique opportunity for vaccinating ...

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Efficacy and Safety of Entecavir and/or Tenofovir for Prophylaxis and Treatment of Hepatitis B Recurrence Post–Liver Transplant

Cited by 62 publications

References 6 publications

Controversies Regarding the Hepatitis B Immune Globulin Prophylaxis (HBIG) for Liver Transplantation Recipients

Controversies Regarding the Hepatitis B Immune Globulin Prophylaxis (HBIG) for Liver Transplantation Recipients

Immunoprophylaxis against and prevention of recurrent viral hepatitis after liver transplantation

Living related liver transplantation for hepatitis B-related liver disease without hepatitis B immune globulin prophylaxis

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