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KMID : 0614620050450030169
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Korean Journal of Gastroenterology
2005 Volume.45 No. 3 p.169 ~ p.173
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Therapeutic Effect of Adefovir Dipivoxil on Recurrent or de novo Infection of Hepatitis B Virus after Liver Transplantation: A Preliminary Report
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김건국/Kim KK
김기훈/황신/안철수/문덕복/하태용/이승규/Kim KH/Hwang S/Ahn CS/Moon DB/Ha TY/Lee SG
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Abstract
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Background/Aims: Anti-viral therapy using hepatitis B immune globulin and lamivudine could not prevent HBV recurrence after liver transplantation (LT) completely. Adefovir dipivoxil is a acyclic nucleotide phosphate analogue and known to have potent anti-HBV effect. In this study, we analyzed the therapeutic effect of adefovir for recurrent or de novo HBV infection after LT. Methods: From December 2002 to October 2004, defovir was administered in 12 post-LT patients of HBV infection (11 recurrent and 1 de novo infection). In these patients, lamivudine and other combined therapies were used before the introduction of adefovir. Thereafter, adefovir combined with lamivudine was dministered to all patients.
Results: The duration of adefovir administration was 5.5-18 (median, 15.5) months. The median values of serum AST and ALT levels were significantly reduced from 86±80 IU/L and 140±103 IU/L, respectively before the adefovir administration to 42±19 IU/L and 38±33 IU/L after 2 months of administration. This trend of improved liver function persisted throughout the follow-up period. HBeAg seroconversion was achieved in 4 of 10 patients (40%) and HBsAg seroconversion was observed in 1 of 10 patients (10%). HBV DNA levels have decreased to undetectable levels by hybridization assay in 6 of 7 patients within the first 2 months of therapy. Nephrotoxicity and hypophosphatemia were not found in all of these patients.
Conclusions: Based on this preliminary result, adefovir dipivoxil seems to be an effective and safe antiviral agent leading to viral inhibition and clinical improvement in post-LT patients with recurrent or de novo HBV infection.
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