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See 1 citation in J Hepatol 2012:

J Hepatol. 2012 Jul;57(1):55-60. doi: 10.1016/j.jhep.2012.02.020. Epub 2012 Mar 10.

Benefits associated with antiviral treatment in kidney allograft recipients with chronic hepatitis B virus infection.

Author information

1
Université Paris Descartes, Unité d'Hépatologie, Assistance Publique Hôpitaux de Paris, Hôpital Cochin et Inserm U-1016, France. sf_cosconea@yahoo.co.uk

Abstract

BACKGROUND & AIMS:

Hepatitis B virus (HBV) infection is more frequent in kidney recipients than in the general population with a higher rate of liver-related morbidity and mortality. We evaluated the benefit associated with HBV viral suppression by nucleos(t)ide analogues treatment in HBV-infected kidney recipients.

METHODS:

This retrospective study included 42 HBsAg-positive kidney recipients, 33 males, 9 females, median age 54 years, followed up during a mean of 15.4±11.8 years after kidney transplantation. Mean treatment duration by single or combined nucleos(t)ide analogues was 6.8±4.3 years. Fibrosis, before treatment, according to Metavir score was: F4 for 6 patients, F3 for 10, F2 for 6, and F0-F1 for 20 patients. The primary end point, the patient survival, was defined as patient death or liver transplantation, the secondary end point was graft survival.

RESULTS:

HBV DNA at the last evaluation was undetectable (<12 IU/ml) in 92.8% of patients. During the follow-up, 8 patients died (17.7%), death being related to hepatocellular carcinoma in 4 (9.5%), including 1 patient with baseline mild fibrosis, and to extrahepatic causes in 4. This mortality rate is strikingly lower than that previously reported in HBV-infected kidney recipients before oral antiviral therapies. Graft survival seems to be improved when compared to the former series.

CONCLUSIONS:

Suppression of HBV replication associated with nucleo(s)tide analogues treatment improves the survival of HBV-infected kidney recipients. Viral suppression does not exclude regular follow-up given the risk of occurrence of hepatocellular carcinoma even in non-cirrhotic patients.

PMID:
22414762
DOI:
10.1016/j.jhep.2012.02.020
[Indexed for MEDLINE]

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