Tenofovir therapy for lamivudine resistance following liver transplantation

Guy W. Neff, Jose Nery, Daryl T Y Lau, Christopher B. O'Brien, Robert Duncan, Norah J. Shire, Phillip Ruiz, Caio Nery, Marzia Montalbano, Halim Muslu, Kamran Safdar, Eugene R. Schiff, Andreas G. Tzakis, Juan R. Madariaga

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Resistant hepatitis B virus (HBV) strains develop in 30% of liver transplant recipients treated with lamivudine within 2 years from the time of transplantation. OBJECTIVE: To assess safety and outcomes of tenofovir salvage therapy for patients with lamivudine resistance in a retrospective cohort of liver-transplanted patients. METHODS: Medical records were retrospectively evaluated for patients who received tenofovir. Data collected included demographics, HBV serologic information prior to and during tenofovir therapy, drug-related complications, and creatinine clearance. Criteria for lamivudine resistance included elevation of liver chemistries along with reappearance of hepatitis B surface antigen, hepatitis Be antigen, and/or HBV DNA. RESULTS: Sixteen patients showed resistance to lamivudine at 10-85 months (median 26) following liver transplantation. Tenofovir 300 mg/day orally was added in 8 patients 1-66 months after the development of viral lamivudine resistance and continued for 14-26 months (median 19.3). All 8 patients experienced HBV DNA viral suppression, with 7 currently nondetectable. No adverse events were reported, and creatinine clearance was not impaired. CONCLUSIONS: Our results suggest that tenofovir safely and markedly decreases replication of lamivudine-resistant HBV variants after liver transplantation and is another potential option for the treatment of HBV lamivudine resistance.

Original languageEnglish
Pages (from-to)1999-2004
Number of pages6
JournalAnnals of Pharmacotherapy
Volume38
Issue number12
DOIs
Publication statusPublished - Dec 2004

Keywords

  • Adefovir
  • Hepatitis B virus
  • Hepatitis C virus
  • Lamivudine
  • Liver transplantation
  • Tenofovir disoproxil fumarate

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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