Hepatitis-B-virus-related fibrosing cholestatic hepatitis after renal transplantation with acute graft failure following interferon-&amp;agr; therapy

Bustillo, Eduardo; Ibarrola, Carolina; Andrés, Amado; Colina, F; Morales, José

doi:10.1093/ndt/13.6.1574

Cited by 12 publications

(9 citation statements)

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“…The use of IFN in organ transplant recipients is limited by its potential to precipitate graft rejection [5]. Lamivudine, an oral nucleoside analogue, inhibits viral DNA replication [6].…”

Section: Discussionmentioning

confidence: 99%

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Valaciclovir for Chronic Hepatitis B Virus Infection after Lung Transplantation

et al. 2004

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We report on a chronic asymptomatic hepatitis B surface antigen (HBsAg) carrier who developed an increase in aminotransferase and HBsAg levels 1 year after lung transplantation. During treatment for cutaneous herpes simplex virus (HSV) infection with oral valaciclovir there was a marked decrease in replicating hepatitis B virus (HBV)-DNA and aminotransferase levels, which was sustained for 9 months by continuing low-dose valaciclovir. A second rise in aminotransferase levels again responded to a valaciclovir dose increase and the HBV-DNA levels declined further. Although we cannot exclude a spontaneous variation of the serologic parameters, our observation suggests that valaciclovir may represent a valuable therapeutic option in the treatment of chronic hepatitis B after lung transplantation.

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“…The use of IFN in organ transplant recipients is limited by its potential to precipitate graft rejection [5]. Lamivudine, an oral nucleoside analogue, inhibits viral DNA replication [6].…”

Section: Discussionmentioning

confidence: 99%

“…Different treatment modalities have been evaluated to decrease viral replication. IFN-␣ has produced favorable results, however, its use in organ transplant recipients is limited by its potential for precipitating graft rejection [5]. Recently, the nucleoside analogue lamivudine has been shown to be a potent inhibitor of HBV [6].…”

Section: Introductionmentioning

confidence: 99%

Valaciclovir for Chronic Hepatitis B Virus Infection after Lung Transplantation

et al. 2004

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“…5,26 Earlier attempts to treat FCH with either interferon 27,28 or lamivudine 10,28 have mostly been disappointing, with no published cases of patients with FCH in the presence of cirrhosis and lamivudine resistance reported to circumvent liver transplantation. An additional therapeutic option is ganciclovir therapy, 29 but treatment is limited by intravenous administration or high tablet burden and limited efficacy.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of fibrosing cholestatic hepatitis using adefovir dipivoxil in a patient with cirrhosis and renal insufficiency

Tillmann¹,

Bock²,

Bleck³

et al. 2003

Liver Transplantation

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Fibrosing cholestatic hepatitis is a deleterious manifestation of hepatitis B virus infection in immunocompromised patients. Without treatment, this condition is usually fatal within weeks of onset. Liver retransplantation has not been successfully performed to date, and treatment intervention was generally unsuccessful before the advent of adefovir dipivoxil. However, concerns have been expressed about the use of this agent in patients who are renally compromised. A 40-year-old liver transplant recipient with hepatitis B virus reinfection, resistance to lamivudine, and fibrosing cholestatic hepatitis complicated by terminal renal impairment and spontaneous bacterial peritonitis was treated with adefovir dipivoxil 10 mg after every dialysis. Since initiating treatment with adefovir dipivoxil 10 mg, a dramatic virologic and clinical improvement was observed in this patient. The patient returned to work full-time within 6 months of starting adefovir dipivoxil without the need for liver retransplantation. Serum HBV DNA (Amplicor HBV; Roche Diagnostics, Basle, Switzerland) decreased by 6 log 10 copies/mL and became negative (< 400 copies/mL) within 8 weeks of treatment and remains negative at the last available assessment. The patient continues to require renal dialysis, but is generally well. H epatitis B virus (HBV) infection is associated with high mortality in immunosuppressed patients. 1-4 A particularly deleterious form of hepatitis B is fibrosing cholestatic hepatitis (FCH), characterized by hepatocyte ballooning degeneration and cellular cholestasis, but only mild inflammatory infiltrates. 5 Although success in treating HBV with nucleoside analogues after transplantation has been achieved, 6-9 similar approaches for the treatment of FCH have, in most cases, failed to prevent liver failure and subsequent death. 10 Successful treatment of FCH has been reported in two lamivudine-treated kidney recipients 11-12 and three patients receiving adefovir dipivoxil. [13][14][15] However, none of these patients had renal impairment.Adefovir dipivoxil, a potent inhibitor of HBV replication, is the orally bioavailable prodrug of adefovir, a nucleotide analogue of adenosine monophosphate. Adefovir dipivoxil 10 mg once daily has shown efficacy against hepatitis B e antigen (HBeAg)-positive chronic hepatitis B, 16 HBeAg-negative (presumed precore mutant) chronic hepatitis B, 17 lamivudine-resistant chronic hepatitis B, 18 and lamivudine-resistant chronic hepatitis B patients co-infected with HIV. 19 Adefovir dipivoxil has just been approved by the FDA.We report the successful treatment with adefovir dipivoxil of a patient suffering from lamivudine-resistant FCH further complicated by pre-existing cirrhosis, terminal kidney insufficiency, and spontaneous bacterial peritonitis. CaseA 33-year-old male patient underwent liver transplantation for HBV-induced cirrhosis in 1993. The patient received prophylactic hepatitis B immunoglobulin, but reinfection, measured by hepatitis B serum surface antigen (HBsAg) positivity, occurred w...

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“…1,2 Extra-articular uric acid deposits, also called tophi, can occur in the absence of gouty arthritis in the connective tissue of ears, breast, kidney, elbows, wrists, fingers, finger pulp, legs, knees, ankles, feet, and toes. [3][4][5][6][7] We report the case of 36-year-old woman with a large urate tophus in the colonic wall resembling a tumor in the absence of gouty arthritis.…”

Section: Intestinal Pseudotumorous Gouty Nodulosis: a Colonic Tophus mentioning

confidence: 99%

“…It has been described mostly in patients after liver transplantation; some cases have also occurred in kidney and bone marrow transplant recipients. [2][3][4][5] Adenovirus infections in general may typically cause upper respiratory tract infections, and, less frequently, lower respiratory infections, gastroenteritis, hemorrhagic cystitis, myocarditis, and keratoconjunctivitis. 6,7 In addition, adenovirus may cause acute hepatitis.…”

Section: Acute Liver Failure In a Renal Transplant Patient Caused By mentioning

confidence: 99%

Acute liver failure in a renal transplant patient caused by adenoviral hepatitis superimposed on a fibrosing cholestatic hepatitis B

et al. 2004

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Hepatitis-B-virus-related fibrosing cholestatic hepatitis after renal transplantation with acute graft failure following interferon-&agr; therapy

Cited by 12 publications

References 0 publications

Valaciclovir for Chronic Hepatitis B Virus Infection after Lung Transplantation

Valaciclovir for Chronic Hepatitis B Virus Infection after Lung Transplantation

Successful treatment of fibrosing cholestatic hepatitis using adefovir dipivoxil in a patient with cirrhosis and renal insufficiency

Acute liver failure in a renal transplant patient caused by adenoviral hepatitis superimposed on a fibrosing cholestatic hepatitis B

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