Effects of Adefovir Dipivoxil plus Hepatitis B Immunoglobulin in Prevention of HBV Recurrence in Patients with HBV-related End-stage Liver Disease after Liver Transplantation
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Adefovir
Hepatitis B
Liver disease
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Objective To investigate the clinical characteristics of hepatitis B recurrence after hepatitis B related liver transplantation.Methods To retrospectively analysis clinical data of the 253 patients who had orthotopic liver transplantation(OLT)for hepatitis B related liver disease from Apr 2005 to Apr 2010.Results There were 16 hepatitis B recurrence in 253 OLT patients and the recurrence rate was 6.32%(16/253).The median time of recurrence was 13 months.The first,third and fifth cumulative recurrence rate were respectively 3.81%(9/236),6.58%(15/228)and 7.14%(16/224).The risk factors for hepatitis B recurrence includes HBeAg positive,HBV DNA positive and YMDD mutants.Chronic hepatitis is clinical manifestations of hepatitis B recurrence after OLT.Hepatitis B immunoglobulin(HBIG)was terminated and nucleoside analogues was modulated.All patients’HBV DNA were controlled less than 500 IU/ml and liver fuction returned to normal.Conclusion OLT is an effective treatment for the hepatitis B correlated end-stage liver disease.Under the prophylaxis of nucleoside analogues and HBIG,hepatitis B recurrence is not the main cause of graft loss and death if it is discovered early and change to quick and effective treatment of anti-hepatitis B virus in time.
Hepatitis B
HBeAg
Liver disease
Hepatitis C
Nucleoside analogue
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1Baskent University Faculty of Medicine, Department of General Surgery, 2Baskent University Faculty of Medicine, Department of Gastroenterology, 3Baskent University Faculty of Medicine, Department of Pediatry
Hepatitis B
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Adefovir
Hepatitis B
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AbstractAdefovir dipivoxil, an acyclic nucleotide analogue, is effective for the treatment of chronic hepatitis B in both hepatitis B e antigen (HBeAg)-positive and -negative patients, with improvement in liver histology, hepatitis B virus (HBV) DNA levels, alanine aminotransferase levels, and HBeAg seroconversion (for HBeAg-positive patients). It is also effective against lamivudine-resistant strains of hepatitis B mutations. It has been studied in pre- and post-liver transplant patients. Compared to lamivudine, adefovir dipivoxil is associated with a much lower risk of emergence of drug-resistant HBV. Adefovir-associated resistant virus is susceptible to lamivudine therapy. The recommended dose of adefovir dipivoxil 10 mg is associated with low risk of nephrotoxicity. Adefovir dipivoxil can be recommended as a first-line treatment but can also be used in patients with chronic hepatitis B infection who are failing lamivudine therapy.Keywordsadefoviradefovir dipivoxilHBV DNAnucleotide analoguetreatment
Adefovir
HBeAg
Hepatitis B
Seroconversion
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The progress in treatment against hepatitis B virus (HBV) with the development of effective and well tolerated nucleotide analogues (NAs) has improved the outcome of patients with HBV decompensated cirrhosis and has prevented post-transplant HBV recurrence.This review summarizes updated issues related to the management of patients with HBV infection before and after liver transplantation (LT).A literature search using the PubMed/Medline databases and consensus documents was performed.Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line NAs for the treatment of patients with HBV decompensated cirrhosis.After LT, the combination of HBV immunoglobulin (HBIG) and NA is considered as the standard of care for prophylaxis against HBV recurrence.The combination of HBIG and lamivudine is related to higher rates of HBV recurrence, compared to the HBIG and entecavir or tenofovir combination.In HBIG-free prophylactic regimens, entecavir and tenofovir should be the first-line options.The choice of treatment for HBV recurrence depends on prior prophylactic therapy, but entecavir and tenofovir seem to be the most attractive options.Finally, liver grafts from hepatitis B core antibody (anti-HBc) positive donors can be safely used in hepatitis B surface antigen negative, preferentially anti-HBc/anti-hepatitis B surface antibody positive recipients.
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Objective: To observe the effect of Adefovir dipivoxil on hepatitis B cirrhosis with ascites at decompensation stage.Methods: Ninty-six hepatitis B cirrhosis cases with ascites at decompensation stage were treated with 10 mg Adefovir dipivoxil once a day for 96 weeks.And 92 hepatitis B cirrhosis cases without anti-virus treatment were selected as control.The clinic effects of two groups were compared.Results: There was significant differences in efficacy and hepatitis B virus negative rate between two groups(P0.01).And both groups showed no side effect.Conclusion: With satisfactory safty,Adefovir dipivoxil is more effective on treating hepatitis B cirrhosis cases with ascites at decompensation stage.
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Decompensation
Hepatitis B
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Adefovir
Hepatitis B
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Objective To study the prevention and treatment of hepatitis B virus recurrence after liver transplantation.Methods Retrospectively analyze the prophylactic strategies and hepatitis B recurrent ratio after liver transplantion.Otherwise to analyze the management of hepatitis B recurrence.Result There are 7 patients diagnosed as hepatitis B recurrence after liver transplantation in 253 patients.HBIG and entecavir and adefovir were used to treat these patients.2 patients became HbsAg undetectable and HbsAg decreased significantly of 2 patients.The efficiency is 57%.Conclusion HBIG together with lamivudine can prevent hepatitis B recurrence after liver transplantation.HBIG,entecavir or adefovir can be a good choice for the treatment of hepatitis B recurrence.
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Adefovir
Hepatitis B
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Abstract Background Adefovir Dipivoxil (ADV) is an important agent to suppress hepatitis B virus (HBV) replication with suboptimal effect on virological and serological response. To optimize Adefovir therapy in chronic hepatitis B (CHB) patients with hepatitis B e antigen (HBeAg) positive, we studied the baseline parameters and on-treatment HBV DNA for favorable outcomes. Methods 48 patients were enrolled in the study and followed up for 5 years prospectively. Baseline characteristics, virological, serological and biochemical parameters as well as on treatment HBV DNA were assessed in prediction of favorable outcomes. Results 1. The patients with baseline alanine aminotransferase (ALT) ≥5 × the upper limit of normal (ULN, 40 IU/L) had higher rates of viral response (VR), HBeAg loss and HBeAg seroconversion at year 5 compared to the patients with ALT < 5 × ULN (VR: 75% vs 43.8%, p = 0.035; HBeAg loss: 43.9% vs 13.8%, p = 0.017; HBeAg seroconversion: 37.9% vs 13.8%, p = 0.035); Patients with baseline HBV DNA < 10 9 copies/ml and ALT ≥3 × ULN had more chance of HBeAg seroconversion (40.9% vs 8.7%, p = 0.012), while in patients with HBeAg < 800 s/co or HBsAg < 5000 IU/ml higher rates of HBeAg loss were achieved. 2. HBV DNA level < 10 4 copies/ml at week 24 was predictive for VR (96.0% vs 40.9%, P < 0.001), HBeAg loss (84.0% vs 36.3%, P = 0.001) and HBeAg seroconversion (36.0% vs 9.1%, P = 0.030). Conclusions ADV treatment should be started for patients with baseline ALT≥5 × ULN or patients with ALT≥3 × ULN and HBV DNA < 10 9 copies/ml. Lower level of HBeAg(< 800 s/co) and HBsAg(< 5000 IU/ml) may be regarded as referenced factors. In patients with serum HBV DNA < 10 4 copies/ml at week 24 the therapy should continue, and a favorable outcome may be achieved in 5 years or longer.
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Seroconversion
Hepatitis B
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Adefovir Dipivoxil for Chemotherapy-Induced Activation of Hepatitis B Virus Infectionto the editor: Adefovir dipivoxil is an oral prodrug of adefovir, an analogue of AMP.Adefovir has recently been used for treatment of chronic infection with hepatitis B virus (HBV), resulting in an improvement in liver histology and a reduction in serum HBV DNA. 1 We describe a case of subfulminant HBV infection that was successfully treated with adefovir.A 69-year-old man with prostate adenocarcinoma (stage D2) and bone metastasis had had intermittent cholestasis of unknown origin years earlier.The patient had completed a course of chemotherapy with mitoxantrone and prednisone 30 days before he was admitted to the hospital for asthenia, anorexia, and jaundice.Laboratory tests revealed an international normalized ratio of 1.61, an alanine aminotransferase level of 990 IU per liter, and a total bilirubin level of 10.7 mg per deciliter
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