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

Abstract

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.

• Authors: Pierluigi Toniutto, Elisabetta Fumo, Maja Caldato, Luca Apollonio, Antonella Perin, Mario Pirisi
• Journal: Transplantation (Transplantation) Vol. 77 Issue 3 Pg. 472-3 (Feb 15 2004) ISSN: 0041-1337 [Print] United States
• PMID: 14966431 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Hepatitis B Antibodies
• Hepatitis B Surface Antigens
• Organophosphonates
• Adenine
• adefovir dipivoxil

Topics

• Acute Disease
• Adenine (analogs & derivatives, therapeutic use)
• Antiviral Agents (therapeutic use)
• Hepatitis B (drug therapy, etiology, immunology)
• Hepatitis B Antibodies (analysis)
• Hepatitis B Surface Antigens (immunology)
• Humans
• Liver Transplantation (adverse effects)
• Male
• Middle Aged
• Organophosphonates