Entecavir treatment in kidney transplant recipients infected with hepatitis B. (17th July 2014)

• Record Type: Journal Article
• Authors: Yap, Desmond Y. H.; Yung, Susan; Tang, Colin S. O.; Seto, Wai Kay; Ma, Maggie K. M.; Mok, Maggie M. Y.; Kwan, Lorraine P. Y.; Chan, Gary C. W.; Choy, Bo Ying; Yuen, Man Fung; Chan, Tak Mao
• Is Part Of: Clinical transplantation. Volume 28:Number 9(2014)
• Page Start: 1010
• Page End: 1015
• Publication Date: 2014-07-17
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12410
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12410-abs-0001"> <title>Abstract</title> <p>Although nucleotide/side analogs improve the clinical outcome of hepatitis B surface antigen‐positive (HBsAg+) kidney transplant recipients (KTR), a significant proportion of subjects have developed resistance to lamivudine (LAM). We retrospectively analyzed the efficacy and tolerability of entecavir (ETV) in HBsAg+ KTR at Queen Mary Hospital during 2005–2013. Twenty‐one patients (10 treatment‐naïve, 11 with LAM resistance) were included (duration of ETV treatment 34.7 ± 22.9 months, range 6–75 months). ETV treatment led to a decline of hepatitis B virus (HBV) DNA titer compared to baseline and is more significant in the treatment‐naïve group (treatment‐naïve: p = 0.028, <0.001 and <0.001; LAM‐resistant p = 0.273, 0.180, and 0.109 after 12, 24, and 36 months). The cumulative rate of HBV DNA undetectability at 12, 24, and 36 months was 60%, 100%, and 100% for treatment‐naïve group, and 27%, 45%, and 45% for LAM‐resistant group, respectively. Time‐to‐HBV DNA undetectability and time‐to‐alanine transaminase (ALT) normalization were 15.7 ± 4.6 and 12.6 ± 3.7 months for treatment‐naïve patients, and 24.5 ± 4.2 and 28.2 ± 3.5 months for those with LAM resistance. Genotypic resistance to ETV emerged after 20.0 ± 3.5 months with increase in ALT and HBV DNA in two patients with LAM resistance, but was not observed in the treatment‐naïve group. Allograft dysfunction, <italic>de novo</italic> cirrhosis, or hepatocellular carcinoma did not occur during follow‐up.</p> </abstract>