Get access

Lamivudine monoprophylaxis for liver transplant recipients with non-replicating hepatitis B virus infection

Authors


Tomoaki Kato, Liver/GI Transplant, University of Miami School of Medicine, 1801 NW 9th Ave 5th Floor, Miami, FL 33136, USA.
Tel.: +1 305 355 5064; fax: +1 305 355 5124;
e-mail: tkato@med.miami.edu

Abstract

Abstract:  Background:  The aim of this study was to evaluate the efficacy of lamivudine (LAM) monoprophylaxis for patients with non-replicating hepatitis B virus (HBV) infection at orthotopic liver transplantation (OLT).

Methods:  Among 128 liver recipients with HBV infection between 1994 and 2004 transplanted at our institution, 60 had non-replicating HBV infection at the time of OLT. Of those, 26 patients received LAM prophylaxis (monoprophylaxis group) and 34 patients received LAM and hepatitis B immunoglobulin (HBIG) prophylaxis (combination group) after OLT.

Results:  Median follow-up after OLT was 67 and 54 months, for monoprophylaxis and combination groups respectively. One and five yr patient/graft survival were 96/85% and 96/80% in monoprophylaxis group, and 85/79% and 67/55% in combination group. HBV DNA was re-detected or increased >105 IU/mL in four patients (15%) at 20–29 month in monoprophylaxis group and six (18%) at 4–35 months in combination group. Recurrent hepatitis was seen in two patients (8%) at 27 and 45 months and monoprophylaxis group and three (9%) at 21–35 months in combination group. The rate of recurrence was not statistically different between two groups.

Conclusion:  LAM monoprophylaxis seemed to be effective for OLT recipients with HBV infection who had non-replicating HBV at transplantation. HBIG administration may play a less valuable role in preventing HBV recurrence in this group of patients.

Get access to the full text of this article

Ancillary