Hepatitis B virus infection and renal transplantation

Ming Chao Tsai, Yen Ta Chen, Yu Shu Chien, Te Chuan Chen, Tsung Hui Hu*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


Although the prevalence of chronic hepatitis B virus (HBV) infection has declined in renal transplant recipients (RTRs), it remains a relevant clinical problem with high morbidity and mortality in long-term follow up. A thorough evaluation, including liver biopsy as well as assessment of HBV replication in serum (i.e. hepatitis B e antigen and/or HBV DNA) is required before transplantation. Interferon should not be used in this setting because of low efficacy and precipitation on acute allograft rejection. The advent of effective antiviral therapies offers the opportunity to prevent the progression of liver disease after renal transplantation. However, as far as we are aware, no studies have compared prophylactic and preemptive strategies. To date, the majority of RTRs with HBV-related liver disease have had a high virological and biochemical response to lamivudine use. However, lamivudine resistance is frequent with a prolonged course of therapy. Considering long-term treatment, antiviral agents with a high genetic barrier to resistance and lack of nephrotoxicity are suggested. The optimal strategy in RTRs with HBV infection remains to be established in the near future.

Original languageEnglish
Pages (from-to)3878-3887
Number of pages10
JournalWorld Journal of Gastroenterology
Issue number31
StatePublished - 21 08 2010


  • Hepatitis B
  • Lamivudine resistance
  • Renal transplantation


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