Adefovir dipivoxil for wait-listed and post-liver transplantation patients with

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Liver Transpl. 2007 Mar;13(3):349-60.

Adefovir dipivoxil for wait-listed and post-liver transplantation patients

with lamivudine-resistant hepatitis B: Final long-term results.

Schiff E, Lai CL, Hadziyannis S, Neuhaus P, Terrault N, Colombo M, Tillmann

H, D, Zeuzem S, Villeneuve JP, Arterburn S, Borroto-Esoda K, Brosgart

C, Chuck S.

Center for Liver Diseases, University of Miami, Miami, FL.

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. Liver Transpl 13:349-360, 2007. © 2007 AASLD.

PMID: 17326221 [PubMed - in process]

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