Adefovir dipivoxil for wait-listed and post-liver transplantation patients with lamivudine-resistant hepatitis B: Final long-term results

Eugene Schiff, Cjing Lung Lai, Stephanos Hadziyannis, Peter Nuehaus, Norah Terrault, Massimo Colombo, Hans Tillmann, Didler Samuel, Stefan Zuezem, Jean Pierre Villenueve, Sarah Arteburn, Katyna Borroto-Esoda, Carol Brosgart, Steven Chuck, Ahmad Obaid Shakil, Jhon Fung, Alfredo Alberti, Anna Lok, Antonio Picciotto, Francesco TorreCaroline Riely, Christian Trepo, Thierry Bizollon, Danielle Bottaa-Fridlund, Rene Gerolami, David Douglas, Dinesh Ranjan, Dominik Faust, Joerg Trojan, Edward Gane, Erica Villa, Modentina Boarino, Etienne Sokal, Peter Starkel, Ferruccio Bonino, Brunetto Maurizio, Fred Gordon, Jo Anne Pratt, Frieder Berr, Ingolf Schiefke, Geoff McCaughan, Simone Strasser, Geoffrey Dusheiko, Georges Philipp Pageaux, Dominique Larrey, Giuseppe Pastore, Teresa Santantonio, Graeme Alexander, Tracy Woodall, Han Van Vlierberghe, Isabelle Colle, Hugh Harley, Jean Guggenheim, Aline Myx-Staccini, Jean Michel Metreau, Philippe Mavier, John Vierling, Tram Tran, Nigel Girgrah, Lisa Nyberg, Man Fung Yuen, Mang Ma, Manuel Delgado Balnco, Manuela Merli, Paola Tanzilli, Mario Angelico, Daniele Di Paolo, Mario Rizzetto, Alfredo Marzano, Pietro Lampertico, Martin Prieto, Marina Berenguer, Martina Felder, Martina Sterneck, Marc Willems, Michael Charlton, Timothy Gunneson, Michael Ritter, Michael Voight, Judy Swift, Mitchell Shiffman, Nicholas Tassopoulos, Isidoros Klissas, Nikolai Naourmov, Patrick Chamouard, Patrick Marcellin, Francois Durand, Peter Angus, Connelly Nathan, Pierluigi Toniutto, Elisabetta Fumo, Pietro Andreone, Carmela Cursaro, Rafael Barcena, Fernando Garcia Hoz, Reinhard Zachoval, Maria Christina, Robert Auke De Man, Herold Metselaar

Research output: Contribution to journalArticlepeer-review

230 Scopus citations

Abstract

Wait-listed (n = 226) or post-liver transplantation (n = 241) chronic hepatitis B (CHB) patients with lamivudine-resistant hepatitis B virus (HBV) were treated with adefovir dipivoxil for a median of 39 and 99 weeks, respectively. Among wait-listed patients, serum HBV DNA levels became undetectable (<l,000 copies/mL) in 59% and 65% at weeks 48 and 96, respectively. After 48 weeks, alanine aminotransferase (ALT), albumin, bilirubin, and prothrombin time normalized in 77%, 76%, 60%, and 84% of wait-listed patients, respectively. Among postransplantation patients, serum HBV DNA levels became undetectable in 40% and 65% at weeks 48 and 96, respectively. After 48 weeks, ALT, albumin, bilirubin, and prothrombin time normalized in 51%, 81%. 76%, and 56% of posttransplantation patients, respectively. Among wait-listed patients who underwent on-study liver transplantation, protection from graft reinfection over a median of 35 weeks was similar among parents who did (n = 34) or did not (n = 23) receive hepatitis B immunoglobulin (HBIg). Hepatitis B surface antigen was detected on the first measurement only in 6% and 9% of patiends who did or did not receive HBIg, respectively. Serum HBV DNA was detected on consecutive visits in 6% and 0% of patients who did or did not receive HBIg, respectively. Treatment-related adverse events led to discontinuation of adefovir dipivoxil in 4% of patients. Cumulative probabilities of resistance were 0%, 2%, and 2% at weeks 48, 96, and 144, respectively. In conclusion, adefovir dipivoxil is effective and safe at wait-listed or posttransplantation CHB patients with lamivudine-resistant HBV and prevents graft reinfection with or without HBIg.

Original languageEnglish (US)
Pages (from-to)349-360
Number of pages12
JournalLiver Transplantation
Volume13
Issue number3
DOIs
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

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