Tenofovir and HBV mutants after liver transplantation

Abstract

Aim:Resistant HBV strains develops in approximately 30% of post liver transplant (LTx) recipients treated with lamivudine(LAM) within 2 years trom nine of transplantatinn. Adetbvir(ADV) has recently been reported to be ettective against mutants, however its use may be limited by nephrotoxicity. We report our experience with tenotbvir(TNV), another nudeotide analogue reverse transcriptase inhibitor, in LTx recipients developing I.AM resistanceMethods:8 pts developed resistance to LAM 10 to 85 mos (median: 26) post-kTx. TNV (300 mg/ day, P.O.) was added 1 to 66 mos after breakthrough (BT), and continued for 2 to 12 mos (mefflan: 4). Prior to receiving TNV, these paUents had been excluded from recewing ADV due to: age> 80 yo. (5), HIV co-infection (1), enhstment in another drug study (1) and potential non-compliance (1). Criteria for BT included elevation of liver chemistries along with reappearance of HBs~g, HBeAg and/or HBVDNA. HBV genotype and ~NIDD variants were identified through DNA sequence analysis prior to and after TNV; sequential HBVDNA levels were measured by hybridization (pts 2,4,6,7&8) or PCR (pts 1,3&5).Results:No adverse reactinn was associated with TNV, The tables below summarize the data pertaining the study pts.Condusion:This preliminary experience indicates that TNV markedly decreases rephcation of L4M-resiatant HBV variants post-kTx These results demonstrate anottaer potential option tbr tfie treatment of HBV L~.lvl resistance