Section Iii—Hepatitis B
Prevention of recurrent hepatitis B post–liver transplantation
- 1Factors associated with a lower rate of recurrent hepatitis B post–liver transplantation (LT) are negative hepatitis B e antigen and/or serum hepatitis B virus DNA pre-LT, hepatitis D virus superinfection, and fulminant hepatitis B.
- 2Long-term intravenous hepatitis B immune globulin (HBIG) monotherapy can reduce the overall rate of recurrent hepatitis B to 20% to 35%.
- 3Long-term lamivudine monotherapy is associated with a risk for drug resistance and overall 3-year rate of recurrent hepatitis B of 40% to 50%.
- 4Combination prophylaxis with HBIG and lamivudine can reduce the overall rate of recurrent hepatitis B to 0% to 10%.
- 5The dose and duration of HBIG therapy needed when used in combination with lamivudine may be lower, but the optimal regimen remains to be determined.
- 6Lamivudine resistance before LT is associated with an increased risk for recurrent hepatitis B post-LT.
- 7A cost-effective prophylactic regimen to prevent recurrent hepatitis B should be tailored according to risk.