Tenofovir Therapy in Hepatitis B Virus-Positive Solid-Organ Transplant Recipients

Daudé, Mathieu; Rostaing, Lionel; Sauné, Karine; Lavayssière, Laurence; Basse, Grégoire; Esposito, Laure; Guitard, Joëlle; Izopet, Jacques; Alric, Laurent; Kamar, Nassim

doi:10.1097/tp.0b013e3182100f59

Cited by 44 publications

(38 citation statements)

References 33 publications

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“…Patients were partial responders to previous therapies with other nucleos(t)ide agents. Renal parameters were stable after 12 months of therapy, and nearly half of the patients were HBV DNA negative at month 12 (33).…”

Section: Tenofovir In Kidney Transplantation and Haemodialysis Patientsmentioning

confidence: 87%

Renal Concerns in the Treatment of Chronic Hepatitis B with Tenofovir

Coppolino

Cernaro

Rivoli

et al. 2017

jrenhep

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Tenofovir, a third generation oral nucleos(t)ide analogue, currently represents one of the first-line drugs recommended for treating chronic hepatitis B virus (HBV) infection. After oral administration, tenofovir is mostly excreted in the urine by glomerular filtration and proximal tubular secretion. Hence, an impaired kidney function may lead to an increased renal exposure to the drug in patients with coexistent renal damage. This could further worsen kidney disease through different mechanisms of nephrotoxicity such as mitochondrial DNA depletion and tubular cytotoxicity. Despite several studies performed so far to assess tenofovir-related renal toxicity, data in HBV patients are not yet conclusive. Screening of risk factors for kidney disease before starting therapy and a careful monitoring of serum creatinine, glomerular filtration rate, serum phosphate and urine analysis during treatment are advocated to adjust the dose or stop treatment if needed. New biomarkers of tubular injury, such as neutrophil gelatinase associated lipocalin, could become helpful in the future for the timely identification and risk stratification of renal damage induced by tenofovir.

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Section: Tenofovir In Kidney Transplantation and Haemodialysis Patientsmentioning

confidence: 87%

Renal Concerns in the Treatment of Chronic Hepatitis B with Tenofovir

Coppolino

Cernaro

Rivoli

et al. 2017

jrenhep

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“…No episodes of acute rejection were reported under therapy. There were no statistically significant changes in renal function represented by stable creatinine levels, estimated creatinine clearance, serum phosphorus level, or daily microalbuminuria level [48] . TDF appears as one of the best options for both NUC naïve and LAM-R RT patients; treatment results have to be extrapolated from the general population since there is little experience in RT.…”

Section: Ridruejo E Nuc Treatment In Rt Patientsmentioning

confidence: 90%

“…It has a high antiviral potency, a high genetic barrier for resistance and a good safety profile [9,10,15] , but there is some concern about its potential nephrotoxicity [47] . There is little data in the renal transplant setting: only one study reports the results of three RT treated patients together with 3 liver, and 1 heart transplant recipients [48] . HBV DNA viral became significantly decreased and 3 patients cleared HBV DNA at the end of the study period.…”

Section: Ridruejo E Nuc Treatment In Rt Patientsmentioning

confidence: 99%

Antiviral treatment for chronic hepatitis B in renal transplant patients

Ridruejo

2014

WJH

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Chronic hepatitis B infection is frequent in renal transplant patients. It negatively impacts long term outcomes reducing graft and patient survival. Current guidelines clearly define who needs treatment, when to start, what is the first line therapy, how to monitor treatment response, when to stop, and how patients must be controlled for its safety. There is some data showing a favorable safety and efficacy profile of nucleos(t)ide analogue (NUC) treatment in the renal transplant setting. Entecavir, a drug without major signs of nephrotoxicity, appears to be the first option for NUC naïve patients and tenofovir remains the preferred choice for patients with previous resistance to lamivudine or any other NUC. Renal transplant recipients under antiHBV therapy should be monitored for its efficacy against HBV but also for its safety with a close renal monitoring. Studies including a large number of patients with long term treatment and follow up are still needed to better demonstrate the safety and efficacy of newer NUCs in this population. Core tip: Nucleos(t)ide analogue treatment is safe and effective in renal transplant patients. It improves long term patients and graft survival.Ridruejo E. Antiviral treatment for chronic hepatitis B in renal transplant patients.

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“…Daude et al (11) initiated tenofovir therapy in seven patients (three kidney transplant recipients, three liver transplant recipients, and one cardiac transplant recipient) with chronic HBV infection and a partial response to adefovir (n=7), lamivudine (n=5), or entecavir (n=5) therapy. HBV DNA clearance was not achieved in all patients.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of tenofovir in the prevention of Hepatitis B virus recurrence following liver transplantation

Hakim

Akarsu²,

Karademir³

et al. 2015

Turk J Gastroenterol

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Background/Aims: In this study, a tenofovir disoproxil fumarate (TDF) + hepatitis B immunoglobulin (HBIG) regimen was compared with lamivudine (LAM) + HBIG to determine the efficacy and safety of TDF in the prevention of hepatitis B virus (HBV) recurrence following liver transplantation (LT). Materials and Methods: Thirty-six patients, 18 treated with TDF+HBIG (TDF group) and 18 with LAM+HBIG (LAM group), were evaluated retrospectively over a median 36-month follow-up in the Liver Transplantation Outpatient Unit of Dokuz Eylül University after having an LT. In the TDF group, TDF treatment was initiated in six patients due to resistance to LAM, in one patient due to relapse, in three patients to prevent relapse, and in eight patients due to de novo hepatitis. In the LAM group, LAM therapy was initiated in two patients due to de novo hepatitis and in 16 patients to prevent relapse. Results: In the TDF group, an increase of greater than 0.5 mg/dL in creatinine values was observed in two patients. In the LAM group, creatinine values did not increase to greater than 0.5 mg/dL. No cases of acute renal failure associated with TDF or LAM, mild or serious adverse events, or HBV recurrence were observed among the patients. Glomerular filtration rates (GFRs) of these patients were calculated with a modification of renal disease (MDRD) formulation. There was no significant difference (p<0.05) in the GFRs between the two groups. Conclusion:The results of this study, after a 36-month follow-up period, were encouraging and demonstrated that TDF therapy is safe and efficacious in treating HBV-positive organ transplant patients. However, patients should be monitored carefully in terms of renal function. Given the limited experience with TDR in LT, this study is of importance due to its long follow-up period.

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Tenofovir Therapy in Hepatitis B Virus-Positive Solid-Organ Transplant Recipients

Cited by 44 publications

References 33 publications

Renal Concerns in the Treatment of Chronic Hepatitis B with Tenofovir

Renal Concerns in the Treatment of Chronic Hepatitis B with Tenofovir

Antiviral treatment for chronic hepatitis B in renal transplant patients

The efficacy and safety of tenofovir in the prevention of Hepatitis B virus recurrence following liver transplantation

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