Author(s): Schiff E, Lai CL, Hadziyannis S, Neuhaus P, Terrault N,
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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 (<1,000 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 posttransplantation 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 patients 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 patients 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 in wait-listed or posttransplantation CHB patients with lamivudine-resistant HBV and prevents graft reinfection with or without HBIg. (c) 2007 AASLD.
This article was published in Liver Transpl
and referenced in Journal of Antivirals & Antiretrovirals