[Therapeutic effect of adefovir dipivoxil on recurrent or de novo infection of hepatitis B virus after liver transplantation: a preliminary report].

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.

• Authors: Keon Kuk Kim, Ki Hun Kim, Shin Hwang, Chul Soo Ahn, Deok Bog Moon, Tae Yong Ha, Sung Gyu Lee
• Journal: The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi (Korean J Gastroenterol) Vol. 45 Issue 3 Pg. 174-80 (Mar 2005) ISSN: 1598-9992 [Print] Korea (South)
• PMID: 15778544 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antiviral Agents
• Organophosphonates
• Reverse Transcriptase Inhibitors
• Lamivudine
• Adenine
• adefovir dipivoxil

Topics

• Adenine (administration & dosage, analogs & derivatives)
• Adult
• Antiviral Agents (administration & dosage)
• Drug Therapy, Combination
• Female
• Hepatitis B, Chronic (drug therapy)
• Humans
• Lamivudine (administration & dosage)
• Liver Transplantation
• Male
• Middle Aged
• Organophosphonates (administration & dosage)
• Recurrence
• Reverse Transcriptase Inhibitors (administration & dosage)