Favourable outcome of adefovir-dipivoxil treatment in acute de novo hepatitis B after liver transplantation1

[Guest guest]

Transplantation 2004; 77(3):472-473

Favourable outcome of adefovir-dipivoxil treatment in acute de novo

hepatitis B after liver transplantation1

Pierluigi Toniutto 2 4; betta Fumo 2; Maja Caldato 2; Luca Apollonio 2;

Antonella Perin 2; Pirisi 3

Adefovir-dipivoxil has been shown to be effective against

lamivudine-resistant mutants in immunocompetent patients and in a small

number of liver transplant recipients with recurrent hepatitis B virus (HBV)

infection. The therapeutic role of adefovir-dipivoxil in acute de novo HBV

infection after transplantation is uncertain. We describe a case of acute de

novo HBV infection that occurred after liver transplantation and that was

treated with lamivudine followed (when viral escape mutants emerged) by

adefovir-dipivoxil rescue. Treatment outcome was excellent, with complete

viral clearance and development of a protective titer of antibodies to

anti-hepatitis B surface antigen. Because the donor was vaccinated against

HBV, it is conceivable that clearance of HBV infection in the recipient

might have been favored by adoptive transfer of immunity to HBV. The immune

status of the donor might be a factor to consider when determining the

treatment options for de novo hepatitis B.

1 This work was supported in part by a grant from " Udinese per la vita "

Organizzazione Non Lucrativa di Utilità Sociale (ONLUS).

2 DPMSC, Medical Liver Transplantation Unit, University of Udine, Udine,

Italy.

3 Department of Medical Sciences, University of East Piedmont " Amedeo

Avogadro, " Novara, Italy.

4 Address correspondence to: Dr. Pierluigi Toniutto, Clinica di Medicina

Interna, Policlinico Universitario, P.le S.M. della Misericordia 1, 33100

Udine, Italy.

Received August 4, 2003.

Revision Requested August 22, 2003.

Accepted September 4, 2003.

[Guest guest]

Transplantation 2004; 77(3):472-473

Favourable outcome of adefovir-dipivoxil treatment in acute de novo

hepatitis B after liver transplantation1

Pierluigi Toniutto 2 4; betta Fumo 2; Maja Caldato 2; Luca Apollonio 2;

Antonella Perin 2; Pirisi 3

Adefovir-dipivoxil has been shown to be effective against

lamivudine-resistant mutants in immunocompetent patients and in a small

number of liver transplant recipients with recurrent hepatitis B virus (HBV)

infection. The therapeutic role of adefovir-dipivoxil in acute de novo HBV

infection after transplantation is uncertain. We describe a case of acute de

novo HBV infection that occurred after liver transplantation and that was

treated with lamivudine followed (when viral escape mutants emerged) by

adefovir-dipivoxil rescue. Treatment outcome was excellent, with complete

viral clearance and development of a protective titer of antibodies to

anti-hepatitis B surface antigen. Because the donor was vaccinated against

HBV, it is conceivable that clearance of HBV infection in the recipient

might have been favored by adoptive transfer of immunity to HBV. The immune

status of the donor might be a factor to consider when determining the

treatment options for de novo hepatitis B.

1 This work was supported in part by a grant from " Udinese per la vita "

Organizzazione Non Lucrativa di Utilità Sociale (ONLUS).

2 DPMSC, Medical Liver Transplantation Unit, University of Udine, Udine,

Italy.

3 Department of Medical Sciences, University of East Piedmont " Amedeo

Avogadro, " Novara, Italy.

4 Address correspondence to: Dr. Pierluigi Toniutto, Clinica di Medicina

Interna, Policlinico Universitario, P.le S.M. della Misericordia 1, 33100

Udine, Italy.

Received August 4, 2003.

Revision Requested August 22, 2003.

Accepted September 4, 2003.

[Guest guest]

Transplantation 2004; 77(3):472-473

Favourable outcome of adefovir-dipivoxil treatment in acute de novo

hepatitis B after liver transplantation1

Pierluigi Toniutto 2 4; betta Fumo 2; Maja Caldato 2; Luca Apollonio 2;

Antonella Perin 2; Pirisi 3

Adefovir-dipivoxil has been shown to be effective against

lamivudine-resistant mutants in immunocompetent patients and in a small

number of liver transplant recipients with recurrent hepatitis B virus (HBV)

infection. The therapeutic role of adefovir-dipivoxil in acute de novo HBV

infection after transplantation is uncertain. We describe a case of acute de

novo HBV infection that occurred after liver transplantation and that was

treated with lamivudine followed (when viral escape mutants emerged) by

adefovir-dipivoxil rescue. Treatment outcome was excellent, with complete

viral clearance and development of a protective titer of antibodies to

anti-hepatitis B surface antigen. Because the donor was vaccinated against

HBV, it is conceivable that clearance of HBV infection in the recipient

might have been favored by adoptive transfer of immunity to HBV. The immune

status of the donor might be a factor to consider when determining the

treatment options for de novo hepatitis B.

1 This work was supported in part by a grant from " Udinese per la vita "

Organizzazione Non Lucrativa di Utilità Sociale (ONLUS).

2 DPMSC, Medical Liver Transplantation Unit, University of Udine, Udine,

Italy.

3 Department of Medical Sciences, University of East Piedmont " Amedeo

Avogadro, " Novara, Italy.

4 Address correspondence to: Dr. Pierluigi Toniutto, Clinica di Medicina

Interna, Policlinico Universitario, P.le S.M. della Misericordia 1, 33100

Udine, Italy.

Received August 4, 2003.

Revision Requested August 22, 2003.

Accepted September 4, 2003.

[Guest guest]

Transplantation 2004; 77(3):472-473

Favourable outcome of adefovir-dipivoxil treatment in acute de novo

hepatitis B after liver transplantation1

Pierluigi Toniutto 2 4; betta Fumo 2; Maja Caldato 2; Luca Apollonio 2;

Antonella Perin 2; Pirisi 3

Adefovir-dipivoxil has been shown to be effective against

lamivudine-resistant mutants in immunocompetent patients and in a small

number of liver transplant recipients with recurrent hepatitis B virus (HBV)

infection. The therapeutic role of adefovir-dipivoxil in acute de novo HBV

infection after transplantation is uncertain. We describe a case of acute de

novo HBV infection that occurred after liver transplantation and that was

treated with lamivudine followed (when viral escape mutants emerged) by

adefovir-dipivoxil rescue. Treatment outcome was excellent, with complete

viral clearance and development of a protective titer of antibodies to

anti-hepatitis B surface antigen. Because the donor was vaccinated against

HBV, it is conceivable that clearance of HBV infection in the recipient

might have been favored by adoptive transfer of immunity to HBV. The immune

status of the donor might be a factor to consider when determining the

treatment options for de novo hepatitis B.

1 This work was supported in part by a grant from " Udinese per la vita "

Organizzazione Non Lucrativa di Utilità Sociale (ONLUS).

2 DPMSC, Medical Liver Transplantation Unit, University of Udine, Udine,

Italy.

3 Department of Medical Sciences, University of East Piedmont " Amedeo

Avogadro, " Novara, Italy.

4 Address correspondence to: Dr. Pierluigi Toniutto, Clinica di Medicina

Interna, Policlinico Universitario, P.le S.M. della Misericordia 1, 33100

Udine, Italy.

Received August 4, 2003.

Revision Requested August 22, 2003.

Accepted September 4, 2003.