Treatment With Adefovir Dipivoxil in a Renal Transplant Patient With Renal Insufficiency and Lamivudine-Resistant Hepatitis B Infection

García, Amaya Redín; Mazuecos, Auxiliadora; González, Patricia; Díaz, Francisco Javier Gómez; Garcia, Tânia Marisa Pisi; Ceballos, M; Rivero, M.

doi:10.1016/j.transproceed.2005.02.010

Cited by 12 publications

(7 citation statements)

References 5 publications

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“…Switching to adefovir dipivoxil with or without continued lamivudine are alternative options. Long-term add-on therapy with adefovir has been found to be consistently effective in several independent studies [39,40,103], even those involving HBeAg-negative cirrhotics [53] and patients who have been imunosuppressed for organ transplant or by co-infection with HIV-1 [52,[104][105][106][107]. Switching to entecavir (at a daily dose of 1 mg rather than 0.5 mg recommended for treatment-naive patients) after lamivudine failure has been shown to be effective in clinical trials [108], but this strategy may encourage development of resistance to entecavir [54].…”

Section: Management Of Pre-existing Nrti Resistancementioning

confidence: 99%

HBV drug resistance: Mechanisms, detection and interpretation

Shaw

Bartholomeusz

Locarnini

2006

Journal of Hepatology

212

178

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Section: Management Of Pre-existing Nrti Resistancementioning

confidence: 99%

HBV drug resistance: Mechanisms, detection and interpretation

Shaw

Bartholomeusz

Locarnini

2006

Journal of Hepatology

212

178

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“…Lamivudine has been used extensively in HBsAg‐positive RT recipients, but its results have been similar to those in other CHB patients . In 5 small series with a total of 32 patients with lamivudine resistance, adefovir often given at a low dosage (2.5–10 mg daily) was reported to offer satisfactory virological responses, but to be associated with renal adverse events in some cases . Because of its potential nephrotoxicity and the current availability of tenofovir, adefovir is not considered to be a preferable treatment option for RT recipients .…”

Section: Introductionmentioning

confidence: 99%

Review article: nucleos(t)ide analogues in patients with chronic hepatitis B virus infection and chronic kidney disease

Pipili¹,

Cholongitas

Papatheodoridis

2013

Aliment Pharmacol Ther

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SUMMARY BackgroundThe treatment of chronic hepatitis B (CHB) in patients with chronic kidney disease (CKD) is based on nucleoside (lamivudine, telbivudine, entecavir) or nucleotide (adefovir, tenofovir) analogues (NAs), but it may be complex and the information is scarce. Entecavir and tenofovir represent the currently recommended first-line NAs for NA-naive CHB patients, while tenofovir is the NA of choice for CHB patients with resistance to nucleosides.

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“…Even though lamivudine is initially effective (HBV DNA negativization rates of 43–78%, HBeAg negativization rates of 0–25%), when given for long periods, rates of resistance are extremely high (∼60%) 10–14. Adefovir has been demonstrated to be safe and effective in patients who have HBV infection with varying degrees of renal dysfunction, but experience is restricted to a low number of lamivudine‐resistant patients 15–17…”

mentioning

confidence: 99%

Entecavir treatment for chronic hepatitis B infection in end‐stage renal disease and kidney transplantation

Ridruejo

Adrover²,

Alonso

et al. 2010

Dialysis & Transplantation

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BACKGROUND The prevalence of chronic hepatitis B virus (HBV) infection is high in patients with end‐stage renal disease and in kidney transplant recipients, and there is little experience with treatment using the newer antiviral drugs. The aim of this study was to assess the efficacy and safety of entecavir in HBV infection in this difficult‐to‐treat population. METHODS Eleven male patients—1 with stage 4 chronic kidney disease, 7 undergoing hemodialysis, and 3 kidney transplant recipients‐were included in the study evaluation. Six were treatment naïve, and 5 were lamivudine resistant. Entecavir was administered at a dose of 0.1–1 mg qd according to the patients' renal function. All were HBsAg positive: 9 were HBeAg (+)/antiHBe (−), and the remaining 2 were HBeAg (−)/antiHBe (+). RESULTS After a median treatment of 2 ± 0.86 years, entecavir therapy was associated with a significant decrease in HBV DNA viral load: it was 6.84 ± 1.45 log10 UI/mL (range 5.21–9.04) at baseline and at the time of evaluation had dropped to 1.73 ± 2.11 log10 UI/mL (range <0.78–4.72). The rate of HBV DNA clearance was 54.5% (n = 6). The rate of anti–HBe seroconversion was 77.7% (7/9 HBeAg‐positive patients). The rate of anti‐HBs seroconversion was 9.1% (1/11 patients). There were no significant changes in renal function or hematological parameters. CONCLUSIONS This small study demonstrates that entecavir therapy is safe and efficient in HBV‐positive patients with varying degrees of renal dysfunction.

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Treatment With Adefovir Dipivoxil in a Renal Transplant Patient With Renal Insufficiency and Lamivudine-Resistant Hepatitis B Infection

Cited by 12 publications

References 5 publications

HBV drug resistance: Mechanisms, detection and interpretation

HBV drug resistance: Mechanisms, detection and interpretation

Review article: nucleos(t)ide analogues in patients with chronic hepatitis B virus infection and chronic kidney disease

Entecavir treatment for chronic hepatitis B infection in end‐stage renal disease and kidney transplantation

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