Adefovir Dipivoxil Therapy in Liver Transplant Recipients With Lamivudine-Resistant Hepatitis B Virus

• Published in: Transplantation proceedings Vol. 37; no. 3; pp. 1507 - 1508
• Main Authors: Herreros de Tejada Echanojáuregui, A., Moreno Planas, J.M., Rubio González, E., Portero Azorin, F., López Monclús, J., Revilla Negro, J., Lucena de la Poza, J.L., Sánchez Turrión, V., Barrios Peinado, C., Cuervas-Mons Martı́nez, V.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-04-2005; Elsevier Science
• Subjects: Adenine - analogs & derivatives; Adenine - therapeutic use; Adult; Aged; Antiviral Agents - therapeutic use; Biological and medical sciences; DNA, Viral - isolation & purification; Drug Resistance, Viral; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hepatitis B - drug therapy; Hepatitis B virus - drug effects; Human viral diseases; Humans; Immunosuppression - methods; Infectious diseases; Lamivudine - therapeutic use; Liver Transplantation - physiology; Medical sciences; Middle Aged; Organophosphonates - therapeutic use; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Viral diseases; Viral hepatitis; Viral Load; Antiretroviral agent; RNA-directed DNA polymerase; Orthohepadnavirus; Hepatic disease; Transplantation; Homotransplantation; Viral hepatitis B; Hepadnaviridae; Surgery; Reverse transcriptase inhibitor; Nucleoside analog; Antiviral; Graft; Hepatitis B virus; Pyrimidine nucleoside; Purine nucleotide; Acyclic nucleotide; Digestive system; Enzyme; Transferases; Enzyme inhibitor; Lamivudine; Organic phosphonate; Infection; Virus; Medicine; Resistance; Nucleotidyltransferases; Adefovir; Treatment; Dideoxynucleoside; Viral disease; Digestive diseases
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2005.02.031

Hepatitis B virus (HBV) infection is the leading cause of cirrhosis worldwide. One effective strategy to prevent recurrence or transmission of HBV infection after liver transplantation exists is prescription of Lamivudine, although it is associated with high resistance rates. Adefovir dipivoxil (AD) is a nucleotide analogue of adenosine that has achieved significant results in virologic, biochemical, and clinical parameters in lamivudine-resistant HBV-infected patients. Between 1990 and 2003 7 adult recipients of ortothopic liver transplants who experienced lamivudine-resistant HBV infection (pretransplantation or posttransplantation) were enrolled in a prospective study to administer AD for 48 weeks. At baseline they showed serum HBV DNA between 2.2 × 10
6 and 1.1 × 10
8 copies/mL. After 48 weeks of AD treatment, the median time-weighted average change in serum HBV DNA (log 10 copies/mL) was −3.19 (SD, 1.65). In 3 patients with HBV, DNA was undetectable (<400 copies/mL) at the end of the follow-up. HBe antigen seroconversion was observed in 1 patient. No significant adverse effects were recorded, except for renal functional impairment in 1 patient who had previous renal insufficiency. In our study, adefovir was an effective drug to suppression HBV replication in liver transplant recipients with lamivudine-resistant HBV. Excluding renal function abnormalities, tolerance of the drug was excellent. None of the patients developed resistance to adefovir. Therapy with AD in liver transplant recipients is effective and safe, although renal function should be monitored closely.