Long-Term Outcome of Renal Transplant Recipients With Chronic Hepatitis B Infection—Impact of Antiviral Treatments

Yap, Desmond Y H; Tang, Chun-Lei; Yung, Susan; Choy, Bo Ying; Yuen, Man Fung; Chan, Tak Mao

doi:10.1097/tp.0b013e3181e5b811

Cited by 63 publications

(67 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HbsAg positivity was shown to be an independent risk factor on 10 years patient survival rate (17), and lamivudine treatment was shown to improve survival rate (19,35). In our study, we found that there was no significant difference between the groups in terms of patient and graft survival rates.…”

Section: Discussionmentioning

confidence: 32%

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Yılmaz

Çetinkaya

Akbaş

et al. 2016

International Surgery

View full text Add to dashboard Cite

Abstract:Aim: Our aim was to compare the short and long term clinical outcomes of HbsAg(+) renal transplant recipients with HbsAg(-) recipients. Patients and Methods: Two hundered and four patients who underwent renal transplantation in our center between 2001 and 2014 were included in the study. The patients were divided into two groups. Group 1: HbsAg(-) group (n=136) and Group 2: HbsAg(+) group (n=68). There was no significant difference between the groups in terms of lymphocyte cross matches, numbers of mismatches, immunosuppressive treatment protocols and induction treatments. In HbsAg(+) group, 51 patients were HBV DNA(+), 64 patients were HbeAg(-) and 4 patients were HbeAg(+). Fifty-seven (83.8%) patients were treated with Lamivudine, 4 (5.9%) patients with Entecavir and 7 (10.3%) patients with Tenofovir for Hepatitis B infection. Graft and patient survival rates, graft functions, acute hepatitis rates, acute rejection rates and other clinical outcomes of the groups were compared. Results: Demographic data and immuologic risk profiles of the groups were similar. Acute rejection rates, graft survival rates and patient survival rates were similar. Acute hepatitis rates, glomerular filtration rates on the last controls and delayed graft function rates were higher in Group 2, while chronic allograft disfunction and new onset Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporationdiabetes mellitus after transplantation (NODAT) rates were similar between the groups. Conclusion: Our study revealed that, graft and patient survival and acute rejection rates were similar between HbsAg(+) and HbsAg(-) recipients, while acute hepatitis rate was higher in HbsAg(+) recipients. Results: Demographic data and immuologic risk profiles of the groups were similar. Acute rejection rates, graft survival rates and patient survival rates were similar. Acute hepatitis rates, glomerular filtration rates on the last controls and delayed graft function rates were higher in Group 2, while chronic allograft disfunction and new onset diabetes mellitus after transplantation (NODAT) rates were similar between the groups. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Conclusion:Our study revealed that, graft and patient survival and acute rejection rates were similar between HbsAg(+) and HbsAg(-) recipients, while acute hepatitis rate was higher in HbsAg(+) recipients.

show abstract

Section: Discussionmentioning

confidence: 32%

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Yılmaz

Çetinkaya

Akbaş

et al. 2016

International Surgery

View full text Add to dashboard Cite

show abstract

“…However, when compared with treatment-naïve the virological response could be fluctuating and relatively slow in LAM-R patients [40] . Nevertheless, rescue therapy with ADV resulted in significantly better viral suppression and liver biochemistry compared with continuation of LAM (75% vs 14.3% had persistent normalization of ALT), and the clinical response was sustained for at least 24 mo [31] .…”

Section: Treatmentmentioning

confidence: 99%

“…When compared with untreated patients, those treated with NUCs showed a significant improvement in survival after 20 years of follow up (34% vs 83% respectively, P < 0.006). Even though NUC therapy reduced overall mortality by reducing liver related disease (P < 0.036), 40% of death in chronic HBV infected patients are still related to liver complications and 22.2% of them developed in patients being treated [31] . Forty two RT patients were treated for long term with different NUCs regimens: at the end of follow up 18 patients were receiving monotherapy (9 LAM, 2 ADV, and ETV) and 24 combination therapy (11 LAM + ADV, 2 LAM + TDF, 4 ETV + ADV, 6 ETV + TDF and 1 TDF + emtricitabine, FTC) [60] .…”

Section: Treatment Impact On Long Term Evolutionmentioning

confidence: 99%

“…In most studies (11 of 14) LAM was administered for 6 to 12 mo [30] . Even though LAM was associated with significantly improved patient survival [31] , prolonged treatment is associated with progressive increase in drug resistance and the cumulative probability of developing LAM resistance (LAM-R) was approximately 60% after 69 mo [30,32,33] . LAM-R leads to treatment failure and can be associated with progressive liver disease and a negative impact in patient and graft survival.…”

Section: Treatmentmentioning

confidence: 99%

“…Several studies had shown that this antiviral effect may impact on long term graft and patients outcome [31,54,[60][61][62] . In 63 LAM treated HBsAg positive RT recipients 10-year survival rate was 81% and such results were nearly comparable to HBsAg negative patients [31] . Initiating treatment with LAM is associated with a 62% chance of developing drug resistance after 4 years of continuous therapy.…”

Section: Treatment Impact On Long Term Evolutionmentioning

confidence: 99%

See 2 more Smart Citations

Antiviral treatment for chronic hepatitis B in renal transplant patients

Ridruejo

2014

WJH

View full text Add to dashboard Cite

Chronic hepatitis B infection is frequent in renal transplant patients. It negatively impacts long term outcomes reducing graft and patient survival. Current guidelines clearly define who needs treatment, when to start, what is the first line therapy, how to monitor treatment response, when to stop, and how patients must be controlled for its safety. There is some data showing a favorable safety and efficacy profile of nucleos(t)ide analogue (NUC) treatment in the renal transplant setting. Entecavir, a drug without major signs of nephrotoxicity, appears to be the first option for NUC naïve patients and tenofovir remains the preferred choice for patients with previous resistance to lamivudine or any other NUC. Renal transplant recipients under antiHBV therapy should be monitored for its efficacy against HBV but also for its safety with a close renal monitoring. Studies including a large number of patients with long term treatment and follow up are still needed to better demonstrate the safety and efficacy of newer NUCs in this population. Core tip: Nucleos(t)ide analogue treatment is safe and effective in renal transplant patients. It improves long term patients and graft survival.Ridruejo E. Antiviral treatment for chronic hepatitis B in renal transplant patients.

show abstract

Update on prevention, diagnosis, and treatment of chronic hepatitis B

et al. 2018

View full text Add to dashboard Cite

Long-Term Outcome of Renal Transplant Recipients With Chronic Hepatitis B Infection—Impact of Antiviral Treatments

Abstract: Treatment of HBsAg+ renal transplant recipients with nucleoside/nucleotide analogues confers long-term survival benefit, and that rescue therapy with adefovir or entecavir is effective and well tolerated in patients who had developed resistance to lamivudine.

Cited by 63 publications

References 25 publications

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Comparison of Clinical Outcomes in Hepatitis B Virus–Positive and –Negative Renal Transplant Recipients

Antiviral treatment for chronic hepatitis B in renal transplant patients

Update on prevention, diagnosis, and treatment of chronic hepatitis B

Contact Info

Product

Resources

About