التفاصيل البيبلوغرافية
| العنوان: |
Outcomes of Patients With Hepatitis B Who Developed Antiviral Resistance While on the Liver Transplant Waiting List. |
| المؤلفون: |
Osborn, Melissa K., Han, Steven H., Regev, Arie, Bzowej, Natalie H., Ishitani, Michael B., Tran, Tram T., Lok, Anna S.F. |
| المصدر: |
Clinical Gastroenterology & Hepatology; Dec2007, Vol. 5 Issue 12, p1454-1461, 8p |
| مصطلحات موضوعية: |
HEPATITIS B, LIVER transplantation, ANTIVIRAL agents, GENOTYPE-environment interaction |
| مستخلص: |
Background & Aims: Lamivudine has been shown to improve liver disease and survival of hepatitis B virus patients on the orthotopic liver transplantation (OLT) waiting list, but liver failure might worsen in patients with drug resistance. Use of antiviral salvage therapy might decrease this risk. Methods: We analyzed data from patients enrolled in the NIH HBV OLT cohort to study the effects of pretransplant antiviral therapy on transplant-free survival and survival without transplant. We also compared the clinical outcomes of those who did or did not develop antiviral failure (virologic breakthrough or genotypic resistance) while awaiting transplant. Results: One hundred twenty-two eligible patients received antiviral therapy before OLT and were followed for a median of 40.5 months (range, 0.4–123.0 months) after initiation of antiviral therapy. Forty-four (36.1%) patients developed antiviral failure; all had lamivudine monotherapy as initial treatment. Forty-two patients started salvage therapy a median of 5 months after lamivudine failure; the median Model for End-Stage Liver Disease (MELD) score was 12. Twenty-one (50%) patients had a full response to salvage therapy. Eleven (26.2%) patients had a suboptimal virologic response but remained clinically compensated. Antiviral failure was not a significant predictor of transplant or death (P = .09) or death without transplant (P = .39). Multivariate predictors of transplant or death were high MELD score, hepatocellular carcinoma, and low albumin. High MELD score and low albumin were predictors of death without transplant. Conclusions: Antiviral failure in patients with HBV on the OLT waiting list did not impair clinical outcome if recognized early and if salvage therapy is promptly initiated. [Copyright &y& Elsevier] |
|
Copyright of Clinical Gastroenterology & Hepatology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Supplemental Index |
Full Text Finder