Prevention of de novo hepatitis B with adefovir dipivoxil in recipients of liver grafts from hepatitis B core antibody-positive donors

Matthew S. Chang, Sonja K. Olsen, Elsa M. Pichardo, Scott Heese, Jessica B. Stiles, Rita Abdelmessih, Elizabeth C. Verna, James V. Guarrera, Jean C. Emond, Robert S. Brown

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Lamivudine has been shown to prevent de novo hepatitis B virus (HBV) infections in liver transplantation (LT) patients receiving hepatitis B core antibody-positive (HBcAb+) grafts, but it may produce long-term resistance. Adefovir dipivoxil (ADV) might be effective in preventing de novo hepatitis and resistance. A single-center, prospective trial was conducted with 16 adults (10 men and 6 women, mean age = 54 ± 11 years) who underwent LT with HBcAb+ grafts between September 2007 and October 2009. After LT, patients were given ADV [10 mg daily (adjusted for renal function)]. No hepatitis B immune globulin was administered. At LT, all graft recipients were hepatitis B surface antigen-negative (HBsAg-), 38% were surface antibody-positive (HBsAb+), and 50% were HBcAb+. The median follow-up after LT was 1.8 years (range = 1.0-2.6 years). All recipients had undetectable HBV DNA (<40 IU/mL) after LT until the end of follow-up. One recipient (6%) who was HBsAb- and HBcAb- before LT became HBsAg+ after 52 weeks. One recipient was switched from ADV to entecavir for chronic renal insufficiency, and 19% of the patients had renal dose adjustments. There was a nonsignificant trend of increasing creatinine levels over time (1.2 mg/dL at LT, 1.3 mg/dL 1 year after LT, and 2.0 mg/dL 2 years after LT, P = 0.27). A comparison with a control cohort of LT recipients with hepatitis C virus who did not receive ADV showed no difference in the creatinine levels at LT or 1 year after LT. In conclusion, ADV prophylaxis prevents HBV replication in recipients of HBcAb+ livers but does not fully protect recipients from de novo HBV. Long-term follow-up is needed to better determine the risk of de novo infection.

Original languageEnglish (US)
Pages (from-to)834-838
Number of pages5
JournalLiver Transplantation
Volume18
Issue number7
DOIs
StatePublished - Jul 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology
  • Transplantation

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    Chang, M. S., Olsen, S. K., Pichardo, E. M., Heese, S., Stiles, J. B., Abdelmessih, R., Verna, E. C., Guarrera, J. V., Emond, J. C., & Brown, R. S. (2012). Prevention of de novo hepatitis B with adefovir dipivoxil in recipients of liver grafts from hepatitis B core antibody-positive donors. Liver Transplantation, 18(7), 834-838. https://doi.org/10.1002/lt.23429