Substitution of tenofovir/emtricitabine for Hepatitis B immune globulin prevents recurrence of Hepatitis B after liver transplantation
Liver International, 07/11/2012
Todd Stravitz R et al. – Substitution of
- Twenty–one recipients without evidence of
HBVrecurrence on HBIg± NAfor ≥6 months were enrolled.
- Patients received their last injection of
HBIg 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
HBsAg, one of whom was non–compliant.
- Two of 3 with recurrence cleared
HBsAg by last follow–up on TDF/ FTC; the non–compliant patient became HBV DNA–undetectable with re–institution of TDF/ FTC.
TDF/ FTCsaved $12,469/year over the standard–of–care, monthly intramuscular HBIg/lamivudine.
- There was no evidence of a general adverse effect of
TDF/ FTCon renal function.
- However, 3 patients developed reversible acute renal failure; on renal biopsy, 1 had possible
TDF/ FTC–induced acute tubular necrosis.