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Article: Entecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation
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TitleEntecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation
 
AuthorsFung, JYY1
Cheung, C1
Chan, SC1
Yuen, MF1
Chok, KSH1
Sharr, W1
Dai, WC
Chan, ACY1
Cheung, TT
Tsang, S1
Lam, B1
Lai, CL1
Lo, CM1
 
Issue Date2011
 
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
 
CitationGastroenterology, 2011, v. 141 n. 4, p. 1212-1219 [How to Cite?]
DOI: http://dx.doi.org/10.1053/j.gastro.2011.06.083
 
AbstractBACKGROUND and AIMS: We investigated the efficacy of entecavir, a cyclopentyl guanosine nucleoside analogue, as monoprophylaxis in patients with chronic hepatitis B who received a liver transplant. METHODS: We studied data from 80 consecutive patients who received a liver transplant (47 from living donors and 33 from deceased donors) for hepatitis B-related disease and entecavir monotherapy as prophylaxis. None of the patients received hepatitis B immunoglobulin. Indications for transplant included decompensation from cirrhosis (27.5%), acute-on-chronic hepatitis B (47.5%), and hepatocellular carcinoma (25%). The median follow-up time was 26 months (range, 5-40 months). Before transplant, 33 patients were not on antiviral therapy and 47 were on oral therapy (18 had received less than 3 months of treatment). RESULTS: At the time of transplant, the median log HBV DNA level was 3.5 copies/mL (range, 1.54-8.81); 21 patients (26%) had undetectable levels of HBV DNA. The cumulative rate of hepatitis B surface antigen (HBsAg) loss was 86% and 91% after 1 and 2 years, respectively. Ten patients had reappearance of HBsAg. Eighteen patients (22.5%) were HBsAg positive at the time of their last examination; 17 of these had undetectable levels of HBV DNA, and the remaining patient had a low level of HBV DNA (217 copies/mL). There was no evidence of mutations at sites that confer resistance to entecavir among patients who were HBsAg positive. CONCLUSIONS: Although only 26% of patients had complete viral suppression at the time of transplant, 91% lost HBsAg, with 98.8% achieving undetectable levels of HBV DNA. A hepatitis B immunoglobulin-free regimen of entecavir monotherapy is effective after liver transplantation for chronic hepatitis B.
 
ISSN0016-5085
2013 Impact Factor: 13.926
 
DOIhttp://dx.doi.org/10.1053/j.gastro.2011.06.083
 
ISI Accession Number IDWOS:000295593700028
Funding AgencyGrant Number
Bristol-Myers Squibb
Funding Information:

The authors disclose the following: Man-Fung Yuen has received speakers' bureau and research grants from Bristol-Myers Squibb. Ching-Lung Lai and James Fung have been invited speakers for Bristol-Myers Squibb. The remaining authors disclose no conflicts.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorFung, JYY
 
dc.contributor.authorCheung, C
 
dc.contributor.authorChan, SC
 
dc.contributor.authorYuen, MF
 
dc.contributor.authorChok, KSH
 
dc.contributor.authorSharr, W
 
dc.contributor.authorDai, WC
 
dc.contributor.authorChan, ACY
 
dc.contributor.authorCheung, TT
 
dc.contributor.authorTsang, S
 
dc.contributor.authorLam, B
 
dc.contributor.authorLai, CL
 
dc.contributor.authorLo, CM
 
dc.date.accessioned2011-08-26T14:24:07Z
 
dc.date.available2011-08-26T14:24:07Z
 
dc.date.issued2011
 
dc.description.abstractBACKGROUND and AIMS: We investigated the efficacy of entecavir, a cyclopentyl guanosine nucleoside analogue, as monoprophylaxis in patients with chronic hepatitis B who received a liver transplant. METHODS: We studied data from 80 consecutive patients who received a liver transplant (47 from living donors and 33 from deceased donors) for hepatitis B-related disease and entecavir monotherapy as prophylaxis. None of the patients received hepatitis B immunoglobulin. Indications for transplant included decompensation from cirrhosis (27.5%), acute-on-chronic hepatitis B (47.5%), and hepatocellular carcinoma (25%). The median follow-up time was 26 months (range, 5-40 months). Before transplant, 33 patients were not on antiviral therapy and 47 were on oral therapy (18 had received less than 3 months of treatment). RESULTS: At the time of transplant, the median log HBV DNA level was 3.5 copies/mL (range, 1.54-8.81); 21 patients (26%) had undetectable levels of HBV DNA. The cumulative rate of hepatitis B surface antigen (HBsAg) loss was 86% and 91% after 1 and 2 years, respectively. Ten patients had reappearance of HBsAg. Eighteen patients (22.5%) were HBsAg positive at the time of their last examination; 17 of these had undetectable levels of HBV DNA, and the remaining patient had a low level of HBV DNA (217 copies/mL). There was no evidence of mutations at sites that confer resistance to entecavir among patients who were HBsAg positive. CONCLUSIONS: Although only 26% of patients had complete viral suppression at the time of transplant, 91% lost HBsAg, with 98.8% achieving undetectable levels of HBV DNA. A hepatitis B immunoglobulin-free regimen of entecavir monotherapy is effective after liver transplantation for chronic hepatitis B.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationGastroenterology, 2011, v. 141 n. 4, p. 1212-1219 [How to Cite?]
DOI: http://dx.doi.org/10.1053/j.gastro.2011.06.083
 
dc.identifier.doihttp://dx.doi.org/10.1053/j.gastro.2011.06.083
 
dc.identifier.eissn1528-0012
 
dc.identifier.epage1219
 
dc.identifier.hkuros192486
 
dc.identifier.hkuros189826
 
dc.identifier.isiWOS:000295593700028
Funding AgencyGrant Number
Bristol-Myers Squibb
Funding Information:

The authors disclose the following: Man-Fung Yuen has received speakers' bureau and research grants from Bristol-Myers Squibb. Ching-Lung Lai and James Fung have been invited speakers for Bristol-Myers Squibb. The remaining authors disclose no conflicts.

 
dc.identifier.issn0016-5085
2013 Impact Factor: 13.926
 
dc.identifier.issue4
 
dc.identifier.openurl
 
dc.identifier.pmid21762659
 
dc.identifier.scopuseid_2-s2.0-80053583302
 
dc.identifier.spage1212
 
dc.identifier.urihttp://hdl.handle.net/10722/137375
 
dc.identifier.volume141
 
dc.languageeng
 
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
 
dc.publisher.placeUnited States
 
dc.relation.ispartofGastroenterology
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAntiviral Agents - adverse effects - therapeutic use
 
dc.subject.meshCarcinoma, Hepatocellular - surgery - virology
 
dc.subject.meshGuanine - adverse effects - analogs and derivatives - therapeutic use
 
dc.subject.meshHepatitis B, Chronic - complications - diagnosis - drug therapy - surgery
 
dc.subject.meshLiver Cirrhosis - surgery - virology
 
dc.titleEntecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation
 
dc.typeArticle
 
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<contributor.author>Chok, KSH</contributor.author>
<contributor.author>Sharr, W</contributor.author>
<contributor.author>Dai, WC</contributor.author>
<contributor.author>Chan, ACY</contributor.author>
<contributor.author>Cheung, TT</contributor.author>
<contributor.author>Tsang, S</contributor.author>
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Author Affiliations
  1. The University of Hong Kong