TY - JOUR
T1 - Posttransplantation hepatitis B prophylaxis with combination oral nucleoside and nucleotide analog therapy
AU - Saab, Sammy
AU - Desai, S.
AU - Tsaoi, D.
AU - Durazo, F.
AU - Han, S.
AU - McClune, A.
AU - Holt, C.
AU - Farmer, D.
AU - Goldstein, L.
AU - Busuttil, R. W.
PY - 2011/3
Y1 - 2011/3
N2 - Liver transplant recipients are at risk of developing recurrent hepatitis B after liver transplantation for hepatitis B virus (HBV)-related liver disease. We evaluated the efficacy of a new hepatitis B prophylaxis regimen involving conversion from at least 12 months of HBIg with lamivudine to combination therapy with an oral nucleoside and nucleotide analog. Between June 2008 and May 2010, a total of 61 liver transplant recipients were converted to a combination of a nucleoside and nucleotide analog. The mean (±standard deviation) follow-up time after conversion was 15.0 (±6.1) months. Recurrent HBV occurred in two (3.3%) patients at 3.1 and 16.6 months after HBIg cessation. The overall person time incidence rate for HBV recurrence after HBIg cessation was 2.7 cases per 100 person-years. The estimate of HBV recurrence was 1.7% at 1 year after HBIg cessation. HBIg cessation a minimum of 12 months after liver transplantation with subsequent combination therapy with a nucleoside and nucleotide analog provides effective prophylaxis against recurrent HBV infection. The clinical implications of HBsAg detection without clinical, biochemical or molecular manifestations of recurrent hepatitis B require further study.
AB - Liver transplant recipients are at risk of developing recurrent hepatitis B after liver transplantation for hepatitis B virus (HBV)-related liver disease. We evaluated the efficacy of a new hepatitis B prophylaxis regimen involving conversion from at least 12 months of HBIg with lamivudine to combination therapy with an oral nucleoside and nucleotide analog. Between June 2008 and May 2010, a total of 61 liver transplant recipients were converted to a combination of a nucleoside and nucleotide analog. The mean (±standard deviation) follow-up time after conversion was 15.0 (±6.1) months. Recurrent HBV occurred in two (3.3%) patients at 3.1 and 16.6 months after HBIg cessation. The overall person time incidence rate for HBV recurrence after HBIg cessation was 2.7 cases per 100 person-years. The estimate of HBV recurrence was 1.7% at 1 year after HBIg cessation. HBIg cessation a minimum of 12 months after liver transplantation with subsequent combination therapy with a nucleoside and nucleotide analog provides effective prophylaxis against recurrent HBV infection. The clinical implications of HBsAg detection without clinical, biochemical or molecular manifestations of recurrent hepatitis B require further study.
KW - Hepatitis B recurrence
KW - Liver transplantation
UR - http://www.scopus.com/inward/record.url?scp=79951992823&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79951992823&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2010.03416.x
DO - 10.1111/j.1600-6143.2010.03416.x
M3 - Article
C2 - 21299826
AN - SCOPUS:79951992823
SN - 1600-6135
VL - 11
SP - 511
EP - 517
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 3
ER -