Virologic and Clinical Outcomes of Hepatitis B Virus Infection in HIV‐HBV Coinfected Transplant Recipients
Liver transplantation (LT) is the treatment of choice for end‐stage liver disease, but is controversial in patients with human immunodeficiency virus (HIV) infection. Using a prospective cohort of HIV‐hepatitis B virus (HBV) coinfected patients transplanted between 2001–2007; outcomes including surv...
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| Veröffentlicht in: | American journal of transplantation 2010-05, Vol.10 (5), p.1268-1275 |
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| creator | Coffin, C. S. Stock, P. G. Dove, L. M. Berg, C. L. Nissen, N. N. Curry, M. P. Ragni, M. Regenstein, F. G. Sherman, K. E. Roland, M. E. Terrault, N. A. |
| description | Liver transplantation (LT) is the treatment of choice for end‐stage liver disease, but is controversial in patients with human immunodeficiency virus (HIV) infection. Using a prospective cohort of HIV‐hepatitis B virus (HBV) coinfected patients transplanted between 2001–2007; outcomes including survival and HBV clinical recurrence were determined. Twenty‐two coinfected patients underwent LT; 45% had detectable HBV DNA pre‐LT and 72% were receiving anti‐HBV drugs with efficacy against lamivudine‐resistant HBV. Post‐LT, all patients received hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues and remained HBsAg negative without clinical evidence of HBV recurrence, with a median follow‐up 3.5 years. Low‐level HBV viremia (median 108 IU/mL, range 9–789) was intermittently detected in 7/13 but not associated with HBsAg detection or ALT elevation. Compared with 20 HBV monoinfected patients on similar HBV prophylaxis and median follow‐up of 4.0 years, patient and graft survival were similar: 100% versus 85% in HBV mono‐ versus coinfected patients (p = 0.08, log rank test). LT is effective for HIV‐HBV coinfected patients with complications of cirrhosis, including those who are HBV DNA positive at the time of LT. Combination HBIG and antivirals is effective as prophylaxis with no clinical evidence of HBV recurrence but low‐level HBV DNA is detectable in ∼50% of recipients.
Post‐transplant outcomes in HIV‐infected persons with HBV‐related liver disease are excellent and recurrent HBV can be prevented with use of combination HBIG and antiviral therapy as prophylaxis, even in those with HBV DNA detectable at the time of transplantation. |
| doi_str_mv | 10.1111/j.1600-6143.2010.03070.x |
| format | Article |
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Post‐transplant outcomes in HIV‐infected persons with HBV‐related liver disease are excellent and recurrent HBV can be prevented with use of combination HBIG and antiviral therapy as prophylaxis, even in those with HBV DNA detectable at the time of transplantation.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/j.1600-6143.2010.03070.x</identifier><identifier>PMID: 20346065</identifier><language>eng</language><publisher>Malden, USA: Blackwell Publishing Inc</publisher><subject>Adult ; Aged ; Antiviral Agents - immunology ; Antiviral Agents - pharmacology ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Graft Survival - immunology ; Hepatitis - drug therapy ; Hepatitis - immunology ; Hepatitis - virology ; Hepatitis B - drug therapy ; Hepatitis B - immunology ; Hepatitis B - virology ; hepatitis B immunoglobulin ; Hepatitis B virus ; Hepatitis B virus (HBV) ; Hepatitis B virus - genetics ; Hepatitis B virus - immunology ; HIV - genetics ; HIV - immunology ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV Infections - virology ; Human viral diseases ; Humans ; immune deficiency ; Immunoglobulins ; Immunologic Deficiency Syndromes - drug therapy ; Immunologic Deficiency Syndromes - immunology ; Infections - drug therapy ; Infections - immunology ; Infections - virology ; Infectious diseases ; Lamivudine - immunology ; Lamivudine - pharmacology ; Lamivudine - therapeutic use ; Liver Cirrhosis - drug therapy ; Liver Cirrhosis - immunology ; Liver Cirrhosis - surgery ; Liver Failure - drug therapy ; Liver Failure - immunology ; Liver Failure - virology ; Liver Transplantation - adverse effects ; Liver Transplantation - immunology ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; polymerase chain reaction ; posttransplant ; posttransplant complications ; posttransplant mortality ; Secondary Prevention ; surface (S) gene ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral hepatitis ; Virus Diseases - drug therapy ; Virus Diseases - immunology ; Virus Diseases - virology ; Viruses - genetics ; Viruses - immunology</subject><ispartof>American journal of transplantation, 2010-05, Vol.10 (5), p.1268-1275</ispartof><rights>©</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-6143.2010.03070.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-6143.2010.03070.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22853206$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20346065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coffin, C. S.</creatorcontrib><creatorcontrib>Stock, P. G.</creatorcontrib><creatorcontrib>Dove, L. M.</creatorcontrib><creatorcontrib>Berg, C. L.</creatorcontrib><creatorcontrib>Nissen, N. N.</creatorcontrib><creatorcontrib>Curry, M. P.</creatorcontrib><creatorcontrib>Ragni, M.</creatorcontrib><creatorcontrib>Regenstein, F. G.</creatorcontrib><creatorcontrib>Sherman, K. E.</creatorcontrib><creatorcontrib>Roland, M. E.</creatorcontrib><creatorcontrib>Terrault, N. A.</creatorcontrib><title>Virologic and Clinical Outcomes of Hepatitis B Virus Infection in HIV‐HBV Coinfected Transplant Recipients</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>Liver transplantation (LT) is the treatment of choice for end‐stage liver disease, but is controversial in patients with human immunodeficiency virus (HIV) infection. Using a prospective cohort of HIV‐hepatitis B virus (HBV) coinfected patients transplanted between 2001–2007; outcomes including survival and HBV clinical recurrence were determined. Twenty‐two coinfected patients underwent LT; 45% had detectable HBV DNA pre‐LT and 72% were receiving anti‐HBV drugs with efficacy against lamivudine‐resistant HBV. Post‐LT, all patients received hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues and remained HBsAg negative without clinical evidence of HBV recurrence, with a median follow‐up 3.5 years. Low‐level HBV viremia (median 108 IU/mL, range 9–789) was intermittently detected in 7/13 but not associated with HBsAg detection or ALT elevation. Compared with 20 HBV monoinfected patients on similar HBV prophylaxis and median follow‐up of 4.0 years, patient and graft survival were similar: 100% versus 85% in HBV mono‐ versus coinfected patients (p = 0.08, log rank test). LT is effective for HIV‐HBV coinfected patients with complications of cirrhosis, including those who are HBV DNA positive at the time of LT. Combination HBIG and antivirals is effective as prophylaxis with no clinical evidence of HBV recurrence but low‐level HBV DNA is detectable in ∼50% of recipients.
Post‐transplant outcomes in HIV‐infected persons with HBV‐related liver disease are excellent and recurrent HBV can be prevented with use of combination HBIG and antiviral therapy as prophylaxis, even in those with HBV DNA detectable at the time of transplantation.</description><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - immunology</subject><subject>Antiviral Agents - pharmacology</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Graft Survival - immunology</subject><subject>Hepatitis - drug therapy</subject><subject>Hepatitis - immunology</subject><subject>Hepatitis - virology</subject><subject>Hepatitis B - drug therapy</subject><subject>Hepatitis B - immunology</subject><subject>Hepatitis B - virology</subject><subject>hepatitis B immunoglobulin</subject><subject>Hepatitis B virus</subject><subject>Hepatitis B virus (HBV)</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B virus - immunology</subject><subject>HIV - genetics</subject><subject>HIV - immunology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - virology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>immune deficiency</subject><subject>Immunoglobulins</subject><subject>Immunologic Deficiency Syndromes - drug therapy</subject><subject>Immunologic Deficiency Syndromes - immunology</subject><subject>Infections - drug therapy</subject><subject>Infections - immunology</subject><subject>Infections - virology</subject><subject>Infectious diseases</subject><subject>Lamivudine - immunology</subject><subject>Lamivudine - pharmacology</subject><subject>Lamivudine - therapeutic use</subject><subject>Liver Cirrhosis - drug therapy</subject><subject>Liver Cirrhosis - immunology</subject><subject>Liver Cirrhosis - surgery</subject><subject>Liver Failure - drug therapy</subject><subject>Liver Failure - immunology</subject><subject>Liver Failure - virology</subject><subject>Liver Transplantation - adverse effects</subject><subject>Liver Transplantation - immunology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>polymerase chain reaction</subject><subject>posttransplant</subject><subject>posttransplant complications</subject><subject>posttransplant mortality</subject><subject>Secondary Prevention</subject><subject>surface (S) gene</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Viral hepatitis</subject><subject>Virus Diseases - drug therapy</subject><subject>Virus Diseases - immunology</subject><subject>Virus Diseases - virology</subject><subject>Viruses - genetics</subject><subject>Viruses - immunology</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFksFuEzEQhi0EoqXwCsgXxClh7PF6NweQ2ghIUKVKKORqeb3e4sixl_UutDcegWfkSfC2IcAJXzya_9PM2PMTQhnMWT6vdnMmAWaSCZxzyFlAKGF-84CcHoWHxxiLE_IkpR0AK3nFH5MTDigkyOKU-K3ro4_XzlAdGrr0LjijPb0aBxP3NtHY0pXt9OAGl-gFzfiY6Dq01gwuBuoCXa23P7__WF1s6TK6O8E2dNPrkDqvw0A_WuM6Z8OQnpJHrfbJPjvcZ-TTu7eb5Wp2efV-vTy_nHVYMZgtTC2axkpZa1ZJNCgq1Iu2NkxLFKaRRW0klsJyJjSUTVsZxiqwUNoauKzxjLy5r9uN9d42JvfutVdd7_a6v1VRO_WvEtxndR2_KmRFkTvmAi8PBfr4ZbRpUHuXjPX5PTaOSZVCIoAs-f9JxAVDVolMPv97qOM0v3eRgRcHQKe8gjb_oHHpD8erAjnIzL2-5745b2-POgM1eUPt1LR2NVlATd5Qd95QN-r8w2aK8BfUKa4B</recordid><startdate>201005</startdate><enddate>201005</enddate><creator>Coffin, C. S.</creator><creator>Stock, P. G.</creator><creator>Dove, L. M.</creator><creator>Berg, C. L.</creator><creator>Nissen, N. N.</creator><creator>Curry, M. P.</creator><creator>Ragni, M.</creator><creator>Regenstein, F. G.</creator><creator>Sherman, K. E.</creator><creator>Roland, M. E.</creator><creator>Terrault, N. A.</creator><general>Blackwell Publishing Inc</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>7T2</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>201005</creationdate><title>Virologic and Clinical Outcomes of Hepatitis B Virus Infection in HIV‐HBV Coinfected Transplant Recipients</title><author>Coffin, C. S. ; Stock, P. G. ; Dove, L. M. ; Berg, C. L. ; Nissen, N. N. ; Curry, M. P. ; Ragni, M. ; Regenstein, F. G. ; Sherman, K. E. ; Roland, M. E. ; Terrault, N. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p3810-9cb4dde66ba1863c3483a9fbc1a634cd65bc6374e214a07df8c1180e07eb026b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - immunology</topic><topic>Antiviral Agents - pharmacology</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Graft Survival - immunology</topic><topic>Hepatitis - drug therapy</topic><topic>Hepatitis - immunology</topic><topic>Hepatitis - virology</topic><topic>Hepatitis B - drug therapy</topic><topic>Hepatitis B - immunology</topic><topic>Hepatitis B - virology</topic><topic>hepatitis B immunoglobulin</topic><topic>Hepatitis B virus</topic><topic>Hepatitis B virus (HBV)</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B virus - immunology</topic><topic>HIV - genetics</topic><topic>HIV - immunology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - virology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>immune deficiency</topic><topic>Immunoglobulins</topic><topic>Immunologic Deficiency Syndromes - drug therapy</topic><topic>Immunologic Deficiency Syndromes - immunology</topic><topic>Infections - drug therapy</topic><topic>Infections - immunology</topic><topic>Infections - virology</topic><topic>Infectious diseases</topic><topic>Lamivudine - immunology</topic><topic>Lamivudine - pharmacology</topic><topic>Lamivudine - therapeutic use</topic><topic>Liver Cirrhosis - drug therapy</topic><topic>Liver Cirrhosis - immunology</topic><topic>Liver Cirrhosis - surgery</topic><topic>Liver Failure - drug therapy</topic><topic>Liver Failure - immunology</topic><topic>Liver Failure - virology</topic><topic>Liver Transplantation - adverse effects</topic><topic>Liver Transplantation - immunology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>polymerase chain reaction</topic><topic>posttransplant</topic><topic>posttransplant complications</topic><topic>posttransplant mortality</topic><topic>Secondary Prevention</topic><topic>surface (S) gene</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Treatment Outcome</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Viral hepatitis</topic><topic>Virus Diseases - drug therapy</topic><topic>Virus Diseases - immunology</topic><topic>Virus Diseases - virology</topic><topic>Viruses - genetics</topic><topic>Viruses - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coffin, C. S.</creatorcontrib><creatorcontrib>Stock, P. G.</creatorcontrib><creatorcontrib>Dove, L. M.</creatorcontrib><creatorcontrib>Berg, C. L.</creatorcontrib><creatorcontrib>Nissen, N. N.</creatorcontrib><creatorcontrib>Curry, M. P.</creatorcontrib><creatorcontrib>Ragni, M.</creatorcontrib><creatorcontrib>Regenstein, F. G.</creatorcontrib><creatorcontrib>Sherman, K. E.</creatorcontrib><creatorcontrib>Roland, M. E.</creatorcontrib><creatorcontrib>Terrault, N. A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coffin, C. S.</au><au>Stock, P. G.</au><au>Dove, L. M.</au><au>Berg, C. L.</au><au>Nissen, N. N.</au><au>Curry, M. P.</au><au>Ragni, M.</au><au>Regenstein, F. G.</au><au>Sherman, K. E.</au><au>Roland, M. E.</au><au>Terrault, N. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Virologic and Clinical Outcomes of Hepatitis B Virus Infection in HIV‐HBV Coinfected Transplant Recipients</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2010-05</date><risdate>2010</risdate><volume>10</volume><issue>5</issue><spage>1268</spage><epage>1275</epage><pages>1268-1275</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>Liver transplantation (LT) is the treatment of choice for end‐stage liver disease, but is controversial in patients with human immunodeficiency virus (HIV) infection. Using a prospective cohort of HIV‐hepatitis B virus (HBV) coinfected patients transplanted between 2001–2007; outcomes including survival and HBV clinical recurrence were determined. Twenty‐two coinfected patients underwent LT; 45% had detectable HBV DNA pre‐LT and 72% were receiving anti‐HBV drugs with efficacy against lamivudine‐resistant HBV. Post‐LT, all patients received hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues and remained HBsAg negative without clinical evidence of HBV recurrence, with a median follow‐up 3.5 years. Low‐level HBV viremia (median 108 IU/mL, range 9–789) was intermittently detected in 7/13 but not associated with HBsAg detection or ALT elevation. Compared with 20 HBV monoinfected patients on similar HBV prophylaxis and median follow‐up of 4.0 years, patient and graft survival were similar: 100% versus 85% in HBV mono‐ versus coinfected patients (p = 0.08, log rank test). LT is effective for HIV‐HBV coinfected patients with complications of cirrhosis, including those who are HBV DNA positive at the time of LT. Combination HBIG and antivirals is effective as prophylaxis with no clinical evidence of HBV recurrence but low‐level HBV DNA is detectable in ∼50% of recipients.
Post‐transplant outcomes in HIV‐infected persons with HBV‐related liver disease are excellent and recurrent HBV can be prevented with use of combination HBIG and antiviral therapy as prophylaxis, even in those with HBV DNA detectable at the time of transplantation.</abstract><cop>Malden, USA</cop><pub>Blackwell Publishing Inc</pub><pmid>20346065</pmid><doi>10.1111/j.1600-6143.2010.03070.x</doi><tpages>8</tpages></addata></record> |
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| ispartof | American journal of transplantation, 2010-05, Vol.10 (5), p.1268-1275 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Antiviral Agents - immunology Antiviral Agents - pharmacology Antiviral Agents - therapeutic use Biological and medical sciences Graft Survival - immunology Hepatitis - drug therapy Hepatitis - immunology Hepatitis - virology Hepatitis B - drug therapy Hepatitis B - immunology Hepatitis B - virology hepatitis B immunoglobulin Hepatitis B virus Hepatitis B virus (HBV) Hepatitis B virus - genetics Hepatitis B virus - immunology HIV - genetics HIV - immunology HIV Infections - drug therapy HIV Infections - immunology HIV Infections - virology Human viral diseases Humans immune deficiency Immunoglobulins Immunologic Deficiency Syndromes - drug therapy Immunologic Deficiency Syndromes - immunology Infections - drug therapy Infections - immunology Infections - virology Infectious diseases Lamivudine - immunology Lamivudine - pharmacology Lamivudine - therapeutic use Liver Cirrhosis - drug therapy Liver Cirrhosis - immunology Liver Cirrhosis - surgery Liver Failure - drug therapy Liver Failure - immunology Liver Failure - virology Liver Transplantation - adverse effects Liver Transplantation - immunology Longitudinal Studies Male Medical sciences Middle Aged polymerase chain reaction posttransplant posttransplant complications posttransplant mortality Secondary Prevention surface (S) gene Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Treatment Outcome Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral hepatitis Virus Diseases - drug therapy Virus Diseases - immunology Virus Diseases - virology Viruses - genetics Viruses - immunology |
| title | Virologic and Clinical Outcomes of Hepatitis B Virus Infection in HIV‐HBV Coinfected Transplant Recipients |
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