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Article: Oral nucleos(t)ide Analogs Alone After Liver Transplantation in Chronic Hepatitis B with Preexisting rt204 Mutation

TitleOral nucleos(t)ide Analogs Alone After Liver Transplantation in Chronic Hepatitis B with Preexisting rt204 Mutation
Authors
Issue Date2017
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
Citation
Transplantation, 2017 How to Cite?
AbstractBACKGROUND: There is currently limited data regarding the use of oral antiviral therapy alone without HBIG for CHB patients with preexisting LAM-resistance (LAM-R) undergoing liver transplantation. METHODS: This is a cohort study determining the effectiveness and long-term outcome in this group of patients. RESULTS: Fifty-seven consecutive CHB patients with preexisting rt204 LAM-R mutations or virological load refractory to LAM undergoing liver transplantation were included, with a median follow-up of 73 months. Fifty-five (96.5%) patients received a regimen that included the use of nucleotide analogs. The cumulative rate of HBsAg seroclearance at 1, 5, and 10 years was 82%, 88%, and 91% respectively. At the time of transplantation, 39 (72%) patients had detectable HBV DNA, with a median of 4.5 log copies/mL. The cumulative rate of HBV undetectability was 91% at 1 year, increasing to 100% by 5 years. After 1 year of liver transplantation, over 90% of patients had undetectable HBV DNA, and from 8 years onwards, 100% had undetectable HBV DNA. The overall long-term survival was excellent, with a 12-year survival of 87%. There was no HBV-related graft loss, and no retransplantation or deaths due to HBV reactivation. CONCLUSION: Oral antiviral therapy alone without HBIG is highly effective in preventing HBV reactivation and graft loss from recurrent hepatitis B after liver transplantation in patients with preexisting lamivudine resistance HBV. The long-term outcome was excellent, with survival of 87% at 12 years after transplantation, without any mortality related to HBV reactivation. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/243161
ISSN
2019 Impact Factor: 4.264
2015 SCImago Journal Rankings: 1.699
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFung, JYY-
dc.contributor.authorWong, CLT-
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, ACY-
dc.contributor.authorSin, SL-
dc.contributor.authorCheung, TT-
dc.contributor.authorDai, WC-
dc.contributor.authorNg, KCK-
dc.contributor.authorNg, KTP-
dc.contributor.authorMan, K-
dc.contributor.authorSeto, WKW-
dc.contributor.authorLai, CL-
dc.contributor.authorYuen, RMF-
dc.contributor.authorLo, CM-
dc.date.accessioned2017-08-25T02:50:54Z-
dc.date.available2017-08-25T02:50:54Z-
dc.date.issued2017-
dc.identifier.citationTransplantation, 2017-
dc.identifier.issn0041-1337-
dc.identifier.urihttp://hdl.handle.net/10722/243161-
dc.description.abstractBACKGROUND: There is currently limited data regarding the use of oral antiviral therapy alone without HBIG for CHB patients with preexisting LAM-resistance (LAM-R) undergoing liver transplantation. METHODS: This is a cohort study determining the effectiveness and long-term outcome in this group of patients. RESULTS: Fifty-seven consecutive CHB patients with preexisting rt204 LAM-R mutations or virological load refractory to LAM undergoing liver transplantation were included, with a median follow-up of 73 months. Fifty-five (96.5%) patients received a regimen that included the use of nucleotide analogs. The cumulative rate of HBsAg seroclearance at 1, 5, and 10 years was 82%, 88%, and 91% respectively. At the time of transplantation, 39 (72%) patients had detectable HBV DNA, with a median of 4.5 log copies/mL. The cumulative rate of HBV undetectability was 91% at 1 year, increasing to 100% by 5 years. After 1 year of liver transplantation, over 90% of patients had undetectable HBV DNA, and from 8 years onwards, 100% had undetectable HBV DNA. The overall long-term survival was excellent, with a 12-year survival of 87%. There was no HBV-related graft loss, and no retransplantation or deaths due to HBV reactivation. CONCLUSION: Oral antiviral therapy alone without HBIG is highly effective in preventing HBV reactivation and graft loss from recurrent hepatitis B after liver transplantation in patients with preexisting lamivudine resistance HBV. The long-term outcome was excellent, with survival of 87% at 12 years after transplantation, without any mortality related to HBV reactivation. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com-
dc.relation.ispartofTransplantation-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.titleOral nucleos(t)ide Analogs Alone After Liver Transplantation in Chronic Hepatitis B with Preexisting rt204 Mutation-
dc.typeArticle-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailWong, CLT: wongtcl@hku.hk-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailDai, WC: daiwc@hku.hk-
dc.identifier.emailNg, KCK: kkcng@hku.hk-
dc.identifier.emailNg, KTP: ledodes@hku.hk-
dc.identifier.emailMan, K: kwanman@hku.hk-
dc.identifier.emailSeto, WKW: wkseto@hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityWong, CLT=rp01679-
dc.identifier.authorityChok, KSH=rp02110-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityNg, KTP=rp01720-
dc.identifier.authorityMan, K=rp00417-
dc.identifier.authoritySeto, WKW=rp01659-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityYuen, RMF=rp00479-
dc.identifier.authorityLo, CM=rp00412-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1097/TP.0000000000001883-
dc.identifier.pmid28731907-
dc.identifier.scopuseid_2-s2.0-85025427208-
dc.identifier.hkuros274711-
dc.identifier.volumeEpub ahead of print-
dc.identifier.isiWOS:000411270000026-
dc.publisher.placeUnited States-
dc.identifier.issnl0041-1337-

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