Use of telbivudine in kidney transplant recipients with chronic hepatitis B virus infection: A preliminary experience

Telbivudine is a relatively novel oral nucleoside analogue with favourable efficacy and tolerability in treatment‐naïve chronic hepatitis B virus (HBV) infection, but its data in kidney transplant recipients (KTRs) was lacking. The efficacy and tolerability of telbivudine in four treatment‐naïve HBsAg‐positive KTRs were reviewed (treatment duration 54 (36–72) months) HBV DNA declined from 2.6 × 105(7.8 × 103–1.5 × 107) copies/mL at baseline to 170 (0.0–3.2 × 104) copies/mL at 12 months, and became undetectable at 24 and 36 months (P = 0.060, 0.118 and 0.005 compared with baseline). Alanine aminotransferase levels dropped from 46.5 (30–48) IU/mL at baseline to 28 (13–45) IU/mL, 34.5 (15–71) IU/mL and 26 (12–41) IU/mL at 12, 24 and 36 months, respectively (P = 0.109, 0.715 and 0.068 compared with baseline). Serum creatinine level and estimated glomerular filtration rate (eGFR) remained stable after 36 months of treatment (P all > 0.05 compared with baseline). No virological breakthrough, cirrhosis or hepatocellular carcinoma occurred. Our pilot data suggests that telbivudine has favourable efficacy and renal safety profiles in HBsAg‐positive KTRs.

[1]  M. Yuen,et al.  Entecavir treatment in kidney transplant recipients infected with hepatitis B , 2014, Clinical transplantation.

[2]  M. Buti,et al.  Telbivudine improves renal function in patients with chronic hepatitis B. , 2014, Gastroenterology.

[3]  Y. Liaw,et al.  Efficacy and safety of continuous 4-year telbivudine treatment in patients with chronic hepatitis B , 2012, Journal of viral hepatitis.

[4]  Chun-Che Lin,et al.  Safety and efficacy of adefovir therapy for lamivudine-resistant hepatitis B virus infection in renal transplant recipients. , 2012, Journal of the Formosan Medical Association = Taiwan yi zhi.

[5]  Wei Zhao,et al.  A prospective and open-label study for the efficacy and safety of telbivudine in pregnancy for the prevention of perinatal transmission of hepatitis B virus infection. , 2011, Journal of hepatology.

[6]  M. Yuen,et al.  Long-Term Outcome of Renal Transplant Recipients With Chronic Hepatitis B Infection—Impact of Antiviral Treatments , 2010, Transplantation.

[7]  Ronald E. Rose,et al.  Long‐term monitoring shows hepatitis B virus resistance to entecavir in nucleoside‐naïve patients is rare through 5 years of therapy , 2009, Hepatology.

[8]  H. Tillmann,et al.  Telbivudine versus lamivudine in patients with chronic hepatitis B. , 2008, The New England journal of medicine.

[9]  T. Hannedouche,et al.  Tenofovir-induced acute renal failure in an HIV patient with normal renal function. , 2005, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[10]  T. Chan,et al.  Rapid quantification of hepatitis B virus DNA by real-time PCR using fluorescent hybridization probes. , 2003, Journal of medical microbiology.

[11]  T. Chan,et al.  Preemptive lamivudine therapy based on HBV DNA level in HBsAg‐positive kidney allograft recipients , 2002, Hepatology.

[12]  P Coriat,et al.  Impact of hepatitis B and C virus on kidney transplantation outcome , 1999, Hepatology.

[13]  J. Chapman,et al.  Predicting glomerular filtration rate after kidney transplantation. , 1995, Transplantation.