Successful withdrawal of antiviral treatment in kidney transplant recipients with chronic hepatitis B viral infection

• DOI: 10.1111/tid.12202
• Publication Date: 2014-03-17T06:27:04Z
• Authors: J.‐H. Cho; J.‐H. Lim; G.‐Y. Park; J.‐S. Kim; Y.‐J. Kang; O. Kwon; J.‐Y. Choi; S.‐H. Park; Y.‐L. Kim; H.‐K. Kim; S. Huh; C.‐D. Kim
• Keywords: Telbivudine; Adefovir; Entecavir; Hepatitis B; Discontinuation; Antiviral Therapy; Antiviral Treatment; Antiviral drug

Abstract Background The optimal duration of antiviral therapy for kidney transplant recipients ( KTR ) with chronic hepatitis B virus HBV infection remains unclear. We reported the long‐term outcomes after withdrawal agent in infection. Methods retrospectively investigated surface antigen HB sAg)‐positive agents between January 2002 and 2012. Antiviral treatments were withdrawn patients who met all following 7 criteria: (i) no clinical histologic evidence cirrhosis, (ii) normal liver biochemistry, (iii) negative both DNA envelope eAg), (iv) resistance to agent, (v) > 9 months, (vi) maintenance dosage immunosuppressant 3 (vii) history acute rejection during recent 6 months. All followed regularly at approximately 3–6 months enzyme, viral markers, level withdrawal. Results Among a total 445 , 14 sAg‐positive included this study. used, lamivudine 11 patients, adefovir, entecavir, telbivudine respectively. Discontinuation was attempted (42.9%) satisfied criteria. median before 14.3 (range, 9–24 months). Four (66.7%) successfully remained 60.5 47–82 baseline not related remission Two reactivated resumed treatment immediately, subsequent normalization . During follow‐up, 1 patient developed hepatocellular carcinoma; however, death or graft failure Conclusions can be discontinued safely selected infection, complete suppression sufficient therapy.