The antiviral treatment impacts on clinical outcomes of renal transplantation recipients with hepatitis B virus infection.

2009 
UNLABELLED: OBJECTIVE; To investigate the clinic outcomes and the efficacy of antiviral treatment in renal transplantation recipients with hepatitis B viral serum markers positive. METHODS: 32 renal transplantation recipients with hepatitis B viral serum markers positive were enrolled. 23 patients in antiviral treatment group have received the lamivudine (19 cases), enticavir (2 cases) and adefovir (1 case). Another 9 patients have not received the antiviral treatment and were as the control group. RESULTS: The biochemical response rate in antiviral treatment group and control group is 82.60% and 22.22%, respectively. 19 of 23 (82.60%) patients in treatment group survived and 1 of 9 (11.11%) patients in control group survived (P < 0.05). 20 of 23 (86.95%) patients in treatment group have the reduction of HBV DNA more than 2 log copies/ml or maintain less than 5 log copies/ml, while 1 of 9 (11.11%) patients in control group has the HBV DNA maintain less than 5 log copies/ml (P < 0.05). The virology rebound was observed in 6 of 19 (31.58%) patients with lamivudine treatment. 2 of them shift to enticavir treatment and 1 of them add adefovir treatment. The three patients survived. Other 3 patients die of liver function failure. CONCLUSION: The antiviral could improve the survival in renal transplantation recipients with hepatitis B viral serum markers positive. When the virology rebound occurs, the add-on with adefovir or the shift to enticavir could be a rescue treatment.
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