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Substitution of tenofovir/emtricitabine for Hepatitis B immune globulin prevents recurrence of Hepatitis B after liver transplantation
Liver International, 07/11/2012
Clinical Article
Todd Stravitz R et al. – Substitution of
- Twenty–one recipients without evidence of
HBV recurrence onHBI g±NA for ≥6 months were enrolled. - Patients received their last injection of
HBI g at the time they initiated tenofovir disoproxil fumarate/emtricitabine (TDF /FTC ; Truvada) and were followed up for 31.1 ± 9.0 [range 15–47] months.
- After 1 year, 3 patients (14%) had detectable
HB sAg, one of whom was non–compliant. - Two of 3 with recurrence cleared
HB sAg by last follow–up onTDF /FTC ; the non–compliant patient becameHBV DNA –undetectable with re–institution ofTDF /FTC . -
TDF /FTC saved $12,469/year over the standard–of–care, monthly intramuscularHBI g/lamivudine. - There was no evidence of a general adverse effect of
TDF /FTC on renal function. - However, 3 patients developed reversible acute renal failure; on renal biopsy, 1 had possible
TDF /FTC –induced acute tubular necrosis.
