| Registro completo |
| Provedor de dados: |
BJID
|
| 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 >5 × ULN and/or >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
|
| Direitos: |
info:eu-repo/semantics/openAccess
|
|
