Effectiveness of Lamividine Combined with Adefovir versus Entecavir for Lamivudineresistant Hepatitis B in Renal Transplant Recipients: A Cohort Study_Chinese Journal of Evidence-Based Medicine

Authors：

 GAOZhi-wen ¹ , XUHui ¹ , LIYa-xin ² ,  LIUKai ²

1. Department of Infectious Diseases, the People's Hospital of Santai County, Mianyang 621100, China;
2. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

LIUKai, Email: liubusiness@163.com

Keywords：

Renal transplantation; HBV; Lamividine; Nucleoside analog-resisitant; Adefovir; Entecavir

DOI：

10.7507/1672-2531.20160136

Video：

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Objective To explore the effectiveness of lamividine (LAM) combined with adefovir (ADV) versus entecavir (ETV) for lamivudine-resistant (LAM-R) hepatitis B in renal transplant recipients. Method Outpatients and inpatients of lamivudine-resistant kidney graft recipients with chronic hepatitis B admitted to West China Hospital and the People's Hospital of Santai County during Jan 2007 to Mar 2012 were divided into A group (LAM+ADV) and B group (ETV). And the level of alanine aminotransferase (ALT), level of serum creatinine, HBV serological markers and HBV-DNA load were compared by SPSS 16.0 software. Results A total of 15 patients were included. The mean age was 36.7±6.6 years old, the majority of patients were male. After treatment for 4 weeks, 12 weeks, 24 weeks, 48 weeks, 96 weeks, no significant differences were found between two groups in liver function normalization rates, the HBV-DNA negative conversion rates and serum creatinine level. Conclusions LAM add-on ADV combination therapy and ETV monotherapy were both safe and effective in LAM-R kidney transplants with CHB, but the load of HBV-DNA in some patients were still positive at the endpoint. Elevated serum creatinine level may occur in some patients who treated with ADV. Consequently, for HBsAg-positive kidney transplantation patients, those anti-HBV drugs that are more effective, safer and less resistant may be better in the beginning of treatment.

Citation： GAOZhi-wen, XUHui, LIYa-xin, LIUKai. Effectiveness of Lamividine Combined with Adefovir versus Entecavir for Lamivudineresistant Hepatitis B in Renal Transplant Recipients: A Cohort Study. Chinese Journal of Evidence-Based Medicine, 2016, 16(8): 882-885. doi: 10.7507/1672-2531.20160136 Copy

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2.	Chan TM, Fang GX, Tang CS, et al. Preemptive lamuvidine therapy based on HBV DNA level in HBsAg-positive kidney allograft recipients. Hepatology, 2002, 36(5):1246-1252.
3.	谢礼波, 秦会胜, 林涛, 等.乙型肝炎病毒感染者肾移植术后随访观察.中华器官移植杂志, 2011, 32(4):249-250.
4.	熊晓峰, 金宏伟, 向德栋.拉米夫定治疗肾移植术后乙型病毒性肝炎的疗效观察.重庆医学, 2006, 35(19):1794.
5.	Zubkin M, Balakirev E, Chervinko V, et al. Treatment of chronic hepatitis B with lamivudine in renal transplant recipients. Int J Artif Organs, 2007, 30(4):308-314.
6.	Murakami R, Amada N, Sato T, et al. Reactivation of hepatitis and lamivudine therapy in 11 HBsAg-positive renal allograft recipients: a single centre experience. Clin Transplant, 2006, 20(3):351-358.
7.	Chan TM1, Tse KC, Tang CS, et al. Prospective Study on Lamivudine-Resistant Hepatitis B in Renal Allograft Recipients. Am J Transplant, 2004, 4(7):1103-1109.
8.	Chen EQ, Wang LC, Lei J, et al. Meta-analysis:adefovir dipivoxil in combination with lamivudine in patients with lamivudine-resistant hepatitis B virus. Virology, 2009, 163(6):1-9.
9.	Tillmann HL, Bock CT, Bleck JS, et al. Successful treatment of fibrosing cholestatic hepatitis using adefovir dipivoxil in patient with cirrhosis and renal insufficiency. Liver Transplant, 2003, 2(9): 191-196.
10.	王甦, 赵连三.乙肝病毒YMDD区变异后不同抗病毒疗法效果的系统评价.中国循证医学杂志, 2004, 4(11):783-788.
11.	中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南(2015版).中华肝脏病杂志, 2015, 23(12):888-905.
12.	Reddy PN, Sampaio MS, Kuo HT, et al. Impact of pre-existing hepatitis B infection on the outcomes of kidney transplant recipients in the United States. Clin J Am Soc Nephrol, 2011, 6(6):1481-1487.
13.	Fabrizi F, Dixit V, Messa P, et al. Management of chronic hepatitis B in special populations:immunosuppressed patients and chronic kidney disease. Curr Hepat Rep, 2011, 10(4):269-276.
14.	Thabut D, Thibault V, Bernard-Chabert B, et al. Long-term therapy with lamivudine in renal transplant recipients with chronic hepatitis B. Eur J Gastroenterol Hepatol, 2004, 16(12):1367-1373.
15.	Lai HW, Chang CC, Chen TH, et al. Safety and efficacy of adefovir therapy for lamivudine-resistant hepatitis B virus infection in renal transplant recipients. Formos Med Assoc, 2012, 111(8):439-444.
16.	Lampertico P, Viganò M, Facchetti F, et al. Long-term add-on therapy with adefovir in lamivudine-resistant kidney graft recipients with chronic hepatitis B. Nephrol Dial Transplant, 2011, 26(6):2037-2041.
17.	Kamar N, Milioto O, Alric L, et al. Entecavir therapy for adefovirresistant hepatitis B virus infection in kidney and liver allograft recipients. Transplantation, 2008, 86(4):611-614.
18.	吴杭源.肾移植乙肝患者使用拉米夫定出现YMDD变异的治疗.现代中西医结合杂志, 2013, 22(4):367-368.
19.	Tse KC, Yap DYH, Tang CSO, et al. Response to adefovir or entecavir in renal allograft recipients with hepatitic flare due to lamivudine-resistant hepatitis B. Clin Transplant, 2010, 24(2):207-212.
20.	Fontaine H, Vallet-Pichard A, Chaix ML, et al. Efficacy and safety of adefovir dipivoxil in kidney recipients, hemodialysis patients, and patients with renal insufficiency. Transplantation, 2005, 80(8):1086-1092.
21.	邹川, 苏国彬, 刘旭生, 等.一例乙肝相关性肾炎伴肾功能衰竭患者的循证治疗.中国循证医学杂志, 2012, 12(3):360-364.

1. Filik L, Karakayali H, Moray G, et al. Lamivudine therapy in kidney allograft recipients who are seropositive for hepatitis B surface antigen. Transplant Proc, 2006, 38(2):496-498.
2. Chan TM, Fang GX, Tang CS, et al. Preemptive lamuvidine therapy based on HBV DNA level in HBsAg-positive kidney allograft recipients. Hepatology, 2002, 36(5):1246-1252.
3. 谢礼波, 秦会胜, 林涛, 等.乙型肝炎病毒感染者肾移植术后随访观察.中华器官移植杂志, 2011, 32(4):249-250.
4. 熊晓峰, 金宏伟, 向德栋.拉米夫定治疗肾移植术后乙型病毒性肝炎的疗效观察.重庆医学, 2006, 35(19):1794.
5. Zubkin M, Balakirev E, Chervinko V, et al. Treatment of chronic hepatitis B with lamivudine in renal transplant recipients. Int J Artif Organs, 2007, 30(4):308-314.
6. Murakami R, Amada N, Sato T, et al. Reactivation of hepatitis and lamivudine therapy in 11 HBsAg-positive renal allograft recipients: a single centre experience. Clin Transplant, 2006, 20(3):351-358.
7. Chan TM1, Tse KC, Tang CS, et al. Prospective Study on Lamivudine-Resistant Hepatitis B in Renal Allograft Recipients. Am J Transplant, 2004, 4(7):1103-1109.
8. Chen EQ, Wang LC, Lei J, et al. Meta-analysis:adefovir dipivoxil in combination with lamivudine in patients with lamivudine-resistant hepatitis B virus. Virology, 2009, 163(6):1-9.
9. Tillmann HL, Bock CT, Bleck JS, et al. Successful treatment of fibrosing cholestatic hepatitis using adefovir dipivoxil in patient with cirrhosis and renal insufficiency. Liver Transplant, 2003, 2(9): 191-196.
10. 王甦, 赵连三.乙肝病毒YMDD区变异后不同抗病毒疗法效果的系统评价.中国循证医学杂志, 2004, 4(11):783-788.
11. 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南(2015版).中华肝脏病杂志, 2015, 23(12):888-905.
12. Reddy PN, Sampaio MS, Kuo HT, et al. Impact of pre-existing hepatitis B infection on the outcomes of kidney transplant recipients in the United States. Clin J Am Soc Nephrol, 2011, 6(6):1481-1487.
13. Fabrizi F, Dixit V, Messa P, et al. Management of chronic hepatitis B in special populations:immunosuppressed patients and chronic kidney disease. Curr Hepat Rep, 2011, 10(4):269-276.
14. Thabut D, Thibault V, Bernard-Chabert B, et al. Long-term therapy with lamivudine in renal transplant recipients with chronic hepatitis B. Eur J Gastroenterol Hepatol, 2004, 16(12):1367-1373.
15. Lai HW, Chang CC, Chen TH, et al. Safety and efficacy of adefovir therapy for lamivudine-resistant hepatitis B virus infection in renal transplant recipients. Formos Med Assoc, 2012, 111(8):439-444.
16. Lampertico P, Viganò M, Facchetti F, et al. Long-term add-on therapy with adefovir in lamivudine-resistant kidney graft recipients with chronic hepatitis B. Nephrol Dial Transplant, 2011, 26(6):2037-2041.
17. Kamar N, Milioto O, Alric L, et al. Entecavir therapy for adefovirresistant hepatitis B virus infection in kidney and liver allograft recipients. Transplantation, 2008, 86(4):611-614.
18. 吴杭源.肾移植乙肝患者使用拉米夫定出现YMDD变异的治疗.现代中西医结合杂志, 2013, 22(4):367-368.
19. Tse KC, Yap DYH, Tang CSO, et al. Response to adefovir or entecavir in renal allograft recipients with hepatitic flare due to lamivudine-resistant hepatitis B. Clin Transplant, 2010, 24(2):207-212.
20. Fontaine H, Vallet-Pichard A, Chaix ML, et al. Efficacy and safety of adefovir dipivoxil in kidney recipients, hemodialysis patients, and patients with renal insufficiency. Transplantation, 2005, 80(8):1086-1092.
21. 邹川, 苏国彬, 刘旭生, 等.一例乙肝相关性肾炎伴肾功能衰竭患者的循证治疗.中国循证医学杂志, 2012, 12(3):360-364.

Chinese Journal of Evidence-Based Medicine

Effectiveness of Lamividine Combined with Adefovir versus Entecavir for Lamivudineresistant Hepatitis B in Renal Transplant Recipients: A Cohort Study

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