Tenofovir therapy for lamivudine resistance following liver transplantation

Guy W. Neff, Jose Nery, Daryl T.Y. Lau, Christopher B. O'Brien, Robert Duncan, Norah J. Shire, Phillip Ruiz, Caio Nery, Marzia Montalbano, Halim Muslu, Kamran Safdar, Eugene R. Schiff, Andreas G. Tzakis, Juan R. Madariaga

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


BACKGROUND: Resistant hepatitis B virus (HBV) strains develop in 30% of liver transplant recipients treated with lamivudine within 2 years from the time of transplantation. OBJECTIVE: To assess safety and outcomes of tenofovir salvage therapy for patients with lamivudine resistance in a retrospective cohort of liver-transplanted patients. METHODS: Medical records were retrospectively evaluated for patients who received tenofovir. Data collected included demographics, HBV serologic information prior to and during tenofovir therapy, drug-related complications, and creatinine clearance. Criteria for lamivudine resistance included elevation of liver chemistries along with reappearance of hepatitis B surface antigen, hepatitis Be antigen, and/or HBV DNA. RESULTS: Sixteen patients showed resistance to lamivudine at 10-85 months (median 26) following liver transplantation. Tenofovir 300 mg/day orally was added in 8 patients 1-66 months after the development of viral lamivudine resistance and continued for 14-26 months (median 19.3). All 8 patients experienced HBV DNA viral suppression, with 7 currently nondetectable. No adverse events were reported, and creatinine clearance was not impaired. CONCLUSIONS: Our results suggest that tenofovir safely and markedly decreases replication of lamivudine-resistant HBV variants after liver transplantation and is another potential option for the treatment of HBV lamivudine resistance.

Original languageEnglish (US)
Pages (from-to)1999-2004
Number of pages6
JournalAnnals of Pharmacotherapy
Issue number12
StatePublished - Dec 2004


  • Adefovir
  • Hepatitis B virus
  • Hepatitis C virus
  • Lamivudine
  • Liver transplantation
  • Tenofovir disoproxil fumarate

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)


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