Data/hora: 10/06/2024 18:08:09

Provedor de dados: 	55	
País: 	Brazil	
Título: 	Acute exacerbation of chronic hepatitis B virus infection in renal transplant patients	
Autores: 	Emori,Christini Takemi; Perez,Renata Melo; Matos,Carla Adriana Loureiro de; Uehara,Silvia Naomi Oliveira; Pereira,Patricia da Silva Fucuta; Feldner,Ana Cristina Amaral; Carvalho Filho,Roberto José de; Silva,Ivonete Sandra de Souza e; Silva,Antonio Eduardo Benedito; Ferraz,Maria Lucia Gomes.	
Data: 	2014-12-01	
Ano: 	2014	
Palavras-chave: 	Renal transplantation; Hepatitis B; ALT flare; Lamivudine.	
Resumo: 	Introduction:There is scarce information regarding clinical evolution of HBV infection in renal transplant patients.Aims:To evaluate the prevalence of acute exacerbation in HBV-infected renal transplant patients and its association with the time after transplantation, presence of viral replication, clinical evolution, and use of antiviral prophylaxis.Materials and methods:HBV infected renal transplant patients who underwent regular follow-up visits at 6-month intervals were included in the study. The criteria adopted to characterize exacerbation were: ALT &gt;5 × ULN and/or &gt;3 × baseline level. Predictive factors of exacerbation evaluated were age, gender, time on dialysis, type of donor, post-transplant time, ALT, HBeAg, HBV-DNA, HCV-RNA, immunosuppressive therapy, and use of antiviral prophylaxis.Results:140 HBV-infected renal transplant patients were included (71% males; age 46 ±10 years; post-renal transplant time 8 ±5 years). During follow-up, 25% (35/140) of the patients presented exacerbation within 3.4 ±3 years after renal transplant. Viral replication was observed in all patients with exacerbation. Clinical and/or laboratory signs of hepatic insufficiency were present in 17% (6/35) of the patients. Three patients died as a consequence of liver failure. In univariate analysis variables associated with exacerbation were less frequent use of prophylactic/preemptive lamivudine and of mycophenolate mofetil. Lamivudine use was the only variable independently associated with exacerbation, with a protective effect.Conclusions:Acute exacerbation was a frequent and severe event in HBV-infected renal transplant patients. Prophylactic/preemptive therapy with antiviral drugs should be indicated for all HBsAg-positive renal transplant patients.	
Tipo: 	Info:eu-repo/semantics/article	
Idioma: 	Inglês	
Identificador: 	http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000600625	
Editor: 	Brazilian Society of Infectious Diseases	
Relação: 	10.1016/j.bjid.2014.06.004	
Formato: 	text/html	
Fonte: 	Brazilian Journal of Infectious Diseases  v.18 n.6 2014	
Fonte: 	info:eu-repo/semantics/openAccess