Efficacy and safety of entecavir and/or tenofovir for prophylaxis and treatment of hepatitis B recurrence post-liver transplant

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Transplant Proc. 2010 Oct;42(8):3167-8.

Efficacy and safety of entecavir and/or tenofovir for prophylaxis and treatment

of hepatitis B recurrence post-liver transplant.

Jiménez-Pérez M, Sáez-Gómez AB, Mongil Poce L, Lozano-Rey JM, de la

Cruz-Lombardo J, Rodrigo-López JM.

Unidad de Hepatología-Trasplante Hepático, Servicio de Aparato Digestivo,

Hospital Universitario Haya, Málaga, Spain. mjimenezp@...

Abstract

AIMS: To establish the efficacy and safety of entecavir (ETV) and/or tenofovir

(TDF) in the treatment and prevention of hepatitis B virus (HBV) recurrence

after liver transplantation.

PATIENTS AND METHODS: Eight patients (four men) received treatment with ETV

and/or TDF after liver transplantation as prophylaxis for HBV recurrence or as

posttransplant treatment of HBV. Four liver transplants were in patients with

HBV-associated cirrhosis who had received prior nucleos(t)ide analogue treatment

until HBV DNA became undetectable. After transplantation, two of these four were

treated with ETV + TDF and the other two with just TDF. All received

intramuscular hepatitis B immunoglobulins. The reasons for the other four liver

transplants were primary biliary cirrhosis in two cases, alcoholic cirrhosis,

and hepatitis C virus. Two of the patients were donor

anti-HBcAb-positive/recipient anti-HBcAb-negative. They received no anti-HBV

prophylaxis so they had a recurrence of HBV. These four patients required

treatment with ETV+TDF for the HBV DNA to become negative.

RESULTS: The mean age was 60 (39-67) years. The mean follow-up was 9.5 (3-20)

months. The mean follow-up of the patients who received prophylaxis was 8.2

(3-19) months. These had no HBV recurrence. The mean follow-up of the patients

who received treatment for HBV recurrence was 12 (3-19) months. ETV combined

with TDF was necessary for the HBV DNA to become undetectable because this was

not possible using different nucleos(t)ide analogues. There were no significant

adverse effects from these drugs and no alteration of renal function during the

follow-up period.

CONCLUSIONS: Therapy with ETV and/or TDF seems to be efficient and safe when

used in the prophylaxis and treatment of HBV recurrence after liver

transplantation. They are well tolerated and seem to have no interactions with

immunosuppressive medication.

Elsevier Inc. All rights reserved.

PMID: 20970638 [PubMed - in process]