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Article: Entecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation

TitleEntecavir monotherapy is effective in suppressing hepatitis B virus after liver transplantation
Authors
Issue Date2011
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Gastroenterology, 2011, v. 141 n. 4, p. 1212-1219 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/137375
ISSN
2014 Impact Factor: 16.716
ISI Accession Number ID
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.

References

 

DC FieldValueLanguage
dc.contributor.authorFung, JYYen_HK
dc.contributor.authorCheung, Cen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorYuen, MFen_HK
dc.contributor.authorChok, KSHen_HK
dc.contributor.authorSharr, Wen_HK
dc.contributor.authorDai, WCen_HK
dc.contributor.authorChan, ACYen_HK
dc.contributor.authorCheung, TTen_HK
dc.contributor.authorTsang, Sen_HK
dc.contributor.authorLam, Ben_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorLo, CMen_HK
dc.date.accessioned2011-08-26T14:24:07Z-
dc.date.available2011-08-26T14:24:07Z-
dc.date.issued2011en_HK
dc.identifier.citationGastroenterology, 2011, v. 141 n. 4, p. 1212-1219en_HK
dc.identifier.issn0016-5085en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137375-
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.en_HK
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastroen_HK
dc.relation.ispartofGastroenterologyen_HK
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 transplantationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0016-5085&volume=141&issue=4&spage=1212&epage=1219&date=2011&atitle=Entecavir+monotherapy+is+effective+in+suppressing+hepatitis+B+virus+after+liver+transplantation-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.emailChan, ACY: acchan@hku.hken_HK
dc.identifier.emailCheung, TT: cheung68@hku.hken_HK
dc.identifier.emailLam, B: bkylam@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityFung, JYY=rp00518en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.identifier.authorityChan, ACY=rp00310en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1053/j.gastro.2011.06.083en_HK
dc.identifier.pmid21762659en_HK
dc.identifier.scopuseid_2-s2.0-80053583302en_HK
dc.identifier.hkuros192486en_US
dc.identifier.hkuros189826-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80053583302&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume141en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1212en_HK
dc.identifier.epage1219en_HK
dc.identifier.eissn1528-0012-
dc.identifier.isiWOS:000295593700028-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, C=7401771672en_HK
dc.identifier.scopusauthoridLai, C=7403086396en_HK
dc.identifier.scopusauthoridLam, B=7102023603en_HK
dc.identifier.scopusauthoridTsang, S=7102255986en_HK
dc.identifier.scopusauthoridCheung, T=7103334165en_HK
dc.identifier.scopusauthoridChan, ACY=15828849100en_HK
dc.identifier.scopusauthoridDai, W=36186690700en_HK
dc.identifier.scopusauthoridSharr, W=36864499000en_HK
dc.identifier.scopusauthoridChok, KSH=6508229426en_HK
dc.identifier.scopusauthoridYuen, M=7102031955en_HK
dc.identifier.scopusauthoridChan, S=7404255575en_HK
dc.identifier.scopusauthoridCheung, C=8714367400en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK

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