Antiviral treatment for chronic hepatitis B in renal transplant patients

World Journal of Hepatology
Ezequiel Ridruejo

Abstract

Chronic hepatitis B infection is frequent in renal transplant patients. It negatively impacts long term outcomes reducing graft and patient survival. Current guidelines clearly define who needs treatment, when to start, what is the first line therapy, how to monitor treatment response, when to stop, and how patients must be controlled for its safety. There is some data showing a favorable safety and efficacy profile of nucleos(t)ide analogue (NUC) treatment in the renal transplant setting. Entecavir, a drug without major signs of nephrotoxicity, appears to be the first option for NUC naïve patients and tenofovir remains the preferred choice for patients with previous resistance to lamivudine or any other NUC. Renal transplant recipients under antiHBV therapy should be monitored for its efficacy against HBV but also for its safety with a close renal monitoring. Studies including a large number of patients with long term treatment and follow up are still needed to better demonstrate the safety and efficacy of newer NUCs in this population.

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Citations

Apr 22, 2017·Journal of Hepatology·UNKNOWN European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, UNKNOWN European Association for the Study of the Liver
Jul 2, 2019·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Kazuharu SuzukiUNKNOWN NORTE Study Group
Mar 7, 2017·World Journal of Hepatology·Bircan Kayaaslan, Rahmet Guner
Mar 19, 2016·Transplant Infectious Disease : an Official Journal of the Transplantation Society·E Durante-MangoniR Zampino
May 18, 2021·Journal of Clinical and Experimental Hepatology·Anil AroraSantosh Varughese

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