Therapeutic Effect of Adefovir Dipivoxil on Recurrent or de novo Infection of Hepatitis B Virus after Liver Transplantation: A Preliminary Report.
- Author:
Keon Kuk KIM
1
;
Ki Hun KIM
;
Shin HWANG
;
Chul Soo AHN
;
Deok Bog MOON
;
Tae Yong HA
;
Sung Gyu LEE
Author Information
1. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. sglee2@amc.seoul.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Adefovir;
Hepatitis B virus;
Liver transplantation;
Lamivudine
- MeSH:
Adenine/administration & dosage/*analogs & derivatives;
Adult;
Antiviral Agents/*administration & dosage;
Drug Therapy, Combination;
English Abstract;
Female;
Hepatitis B, Chronic/*drug therapy;
Humans;
Lamivudine/administration & dosage;
*Liver Transplantation;
Male;
Middle Aged;
Phosphonic Acids/*administration & dosage;
Recurrence;
Reverse Transcriptase Inhibitors/administration & dosage
- From:The Korean Journal of Gastroenterology
2005;45(3):174-180
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Anti-viral therapy using hepatitis B immune globulin and lamivudine could not prevent HBV recurrence after liver transplantation (LT) completely. Adefovir dipivoxil is a acyclic nucleotide phosphate analogue and known to have potent anti-HBV effect. In this study, we analyzed the therapeutic effect of adefovir for recurrent or de novo HBV infection after LT. METHODS: From December 2002 to October 2004, adefovir was administered in 12 post-LT patients of HBV infection (11 recurrent and 1 de novo infection). In these patients, lamivudine and other combined therapies were used before the introduction of adefovir. Thereafter, adefovir combined with lamivudine was administered to all patients. RESULTS: The duration of adefovir administration was 5.5-18 (median, 15.5) months. The median values of serum AST and ALT levels were significantly reduced from 86+/-80 IU/L and 140+/-103 IU/L, respectively before the adefovir administration to 42+/-19 IU/L and 38+/-33 IU/L after 2 months of administration. This trend of improved liver function persisted throughout the follow-up period. HBeAg seroconversion was achieved in 4 of 10 patients (40%) and HBsAg seroconversion was observed in 1 of 10 patients (10%). HBV DNA levels have decreased to undetectable levels by hybridization assay in 6 of 7 patients within the first 2 months of therapy. Nephrotoxicity and hypophosphatemia were not found in all of these patients. CONCLUSIONS: Based on this preliminary result, adefovir dipivoxil seems to be an effective and safe antiviral agent leading to viral inhibition and clinical improvement in post-LT patients with recurrent or de novo HBV infection.
