Outcomes in liver transplant recipients with hepatitis B virus: Resistance and recurrence patterns from a large transplant center over the last decade

Guy W. Neff, Christopher B O'Brien, Jose Nery, Norah Shire, Marzia Montalbano, Phillip Ruiz, Ciao Nery, Kamran Safdar, Maria De Medina, Andreas G. Tzakis, Eugene R Schiff, Juan Madariaga

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Hepatitis B virus (HBV) recurrence following liver transplantation (LTx) has been controllable primarily with the use of hepatitis B immune globulin (HBIg) and lamivudine (LAM). However, HBV resistance to LAM and/or HBIg has become an increasing problem prompting the use of newer antiviral agents. The purpose of our study was to investigate the association between therapy, HBV breakthrough, and allograft / patient survival in HBV-positive liver transplant recipients. We performed a retrospective review of the medical records of patients that were transplanted for HBV from June 1994 to May 2003. A total of 92 patients, positive for either hepatitis B surface antigen (HBsAg) or HBV deoxyribonucleic acid (DNA) pretransplant, received LAM monotherapy or HBIg (6 months) plus LAM therapy post-liver transplant. HBV breakthrough post-LTx was noted in 14 patients. All patients had detectable HBV DNA prior to liver transplantation; none of the patients that were HBV DNA negative prior to transplant had detectable HBV DNA posttransplant. Of these 14, 9 patients (64%) were switched from LAM to adefovir dipivoxil (ADF) and 5 patients (36%) to tenofovir disoproxil fumarate (TNV). In conclusion, pre-LTx HBV viremia should be considered in planning post-LTx prophylaxis. Trials to evaluate oral antiviral agents in combination with or without HBIg therapy are needed.

Original languageEnglish
Pages (from-to)1372-1378
Number of pages7
JournalLiver Transplantation
Volume10
Issue number11
DOIs
StatePublished - Nov 1 2004

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Hepatitis B virus
Transplants
Recurrence
Liver
Lamivudine
Hepatitis B
Immunoglobulins
Tenofovir
DNA
Liver Transplantation
Antiviral Agents
Transplant Recipients
Viremia
Hepatitis B Surface Antigens
Medical Records
Allografts
Therapeutics
Survival

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Outcomes in liver transplant recipients with hepatitis B virus : Resistance and recurrence patterns from a large transplant center over the last decade. / Neff, Guy W.; O'Brien, Christopher B; Nery, Jose; Shire, Norah; Montalbano, Marzia; Ruiz, Phillip; Nery, Ciao; Safdar, Kamran; De Medina, Maria; Tzakis, Andreas G.; Schiff, Eugene R; Madariaga, Juan.

In: Liver Transplantation, Vol. 10, No. 11, 01.11.2004, p. 1372-1378.

Research output: Contribution to journalArticle

Neff, Guy W. ; O'Brien, Christopher B ; Nery, Jose ; Shire, Norah ; Montalbano, Marzia ; Ruiz, Phillip ; Nery, Ciao ; Safdar, Kamran ; De Medina, Maria ; Tzakis, Andreas G. ; Schiff, Eugene R ; Madariaga, Juan. / Outcomes in liver transplant recipients with hepatitis B virus : Resistance and recurrence patterns from a large transplant center over the last decade. In: Liver Transplantation. 2004 ; Vol. 10, No. 11. pp. 1372-1378.
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