Prevention and Management of HBV Infection in Patients with Chronic Kidney Disease Requiring Renal Transplantation
Purpose of the Review
This review addresses clinical challenges of hepatitis B virus (HBV) infection in patients with chronic kidney disease and renal transplant recipients.
Prophylactic antiviral therapy with nucleos(t)ide analogues is key to prevent HBV reactivation in renal transplant recipients. In addition, attaining adequate immunity following vaccination against HBV may permit transplantation of renal grafts from donors with evidence of prior HBV infection. The role of nucleos(t)ide analogues for treatment of recurrent or de novo HBV infection in renal transplant recipients is well established and preliminary experience demonstrate significant reductions in the median time in the renal transplant waiting list by transplanting HBsAg-positive renal grafts into HBsAg-positive recipients, without sacrificing graft or patient survival with the use of these agents.
Availability of potent nucleos(t)ide analogues results in improved outcomes following renal transplantation in patients with chronic HBV infection by avoiding recurrent or de novo infection.
KeywordsHepatitis B Chronic kidney disease Dialysis Renal transplantation Immunosuppression
Compliance with Ethical Standards
Conflicts of Interest
Andres F. Carrion reports personal fees from Gilead, personal fees from BMS, during the conduct of the study. Paul Martin reports grants and personal fees from Gilead, grants and personal fees from BMS, during the conduct of the study.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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