Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2015; 7(2): 189-203
Published online Feb 27, 2015. doi: 10.4254/wjh.v7.i2.189
Antiviral treatment for chronic hepatitis B in renal transplant patients
Ezequiel Ridruejo
Ezequiel Ridruejo, Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Ciudad Autónoma de Buenos Aires, C1425ASG Buenos Aires, Argentina
Ezequiel Ridruejo, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, 1629 Provincia de Buenos Aires, Argentina
Author contributions: Ridruejo E analyzed all the data and wrote the paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Ezequiel Ridruejo, MD, Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno “CEMIC”, Avda. Las Heras 2939, C1425ASG Buenos Aires, Argentina.
Telephone: +54-11-48091980 Fax: +54-11-48091992
Received: August 13, 2014
Peer-review started: August 14, 2014
First decision: October 14, 2014
Revised: November 7, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 27, 2015

Chronic hepatitis B infection is frequent in renal transplant patients. It negatively impacts long term outcomes reducing graft and patient survival. Current guidelines clearly define who needs treatment, when to start, what is the first line therapy, how to monitor treatment response, when to stop, and how patients must be controlled for its safety. There is some data showing a favorable safety and efficacy profile of nucleos(t)ide analogue (NUC) treatment in the renal transplant setting. Entecavir, a drug without major signs of nephrotoxicity, appears to be the first option for NUC naïve patients and tenofovir remains the preferred choice for patients with previous resistance to lamivudine or any other NUC. Renal transplant recipients under antiHBV therapy should be monitored for its efficacy against HBV but also for its safety with a close renal monitoring. Studies including a large number of patients with long term treatment and follow up are still needed to better demonstrate the safety and efficacy of newer NUCs in this population.

Keywords: Tenofovir, Long term outcome, Hepatitis B, Renal transplantation, Entecavir

Core tip: Nucleos(t)ide analogue treatment is safe and effective in renal transplant patients. It improves long term patients and graft survival.