Conflict of interest: None.
Long-term outcome of patients with lamivudine after early cessation of hepatitis B immunoglobulin for prevention of recurrent hepatitis B following liver transplantation
Article first published online: 15 JUN 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 4, pages 517–522, July/August 2011
How to Cite
Yuefeng, M., Weili, F., Wenxiang, T., Ligang, X., Guiling, L., Hongwei, G., Wencai, L., Xiaoguang, W., Wei, M. and Zhongyi, F. (2011), Long-term outcome of patients with lamivudine after early cessation of hepatitis B immunoglobulin for prevention of recurrent hepatitis B following liver transplantation. Clinical Transplantation, 25: 517–522. doi: 10.1111/j.1399-0012.2010.01290.x
- Issue published online: 16 AUG 2011
- Article first published online: 15 JUN 2010
- Accepted for publication 27 April 2010
- hepatitis B;
- hepatitis B immunoglobulin;
- liver transplantation
Yuefeng M, Weili F, Wengxiang T, Ligang X, Guiling L, Hongwei G, Wencai L, Xiaoguang W, Wei M, Zhongyi F. Long-term outcome of patients with lamivudine after early cessation of hepatitis B immunoglobulin for prevention of recurrent hepatitis B following liver transplantation. Clin Transplant 2011: 25: 517–522. © 2010 John Wiley & Sons A/S.
Abstract: Background: The aim of this study is to examine the efficacy of long-term prophylaxis with lamivudine (LAM) after a course of post-operative hepatitis B immunoglobulin (HBIG) in patients who underwent liver transplantation (LT) for hepatitis B virus (HBV)-related disease.
Result: The medical records of HBV-infected patients who underwent a LT in our institution between July 2001 and May 2005 were reviewed. There were 15 liver transplant recipients who were administered HBIG for <18 months and used LAM as a maintenance prophylaxis regime enrolled in this study. At enrollment, all patients were hepatitis B surface antigen (HBsAg) positive and three patients were HBeAg positive. There were 13 patients who were HBV DNA positive with a mean viral load of 5.4 log copies/mL, and among them, 12 recipients were on antiviral therapy with LAM (100 mg/d orally) for 12–168 d, resulting in HBV DNA negative levels in nine patients prior to their transplant. HBV recurrence post-LT was noted in two patients who had very high-HBV DNA levels pre-LT. Both of these patients showed LAM-resistant mutation at the time of recurrence. The 11 patients who were HBV DNA negative before LT (low-risk patients) had no HBV recurrence during a follow-up at a median of 58 months post-LT. This included five patients who had intermittent low-level HBV DNA post-LT (HBsAg negative), of whom two had YMDD mutation and these two were given adefovir in addition to LAM.
Conclusion: Our retrospective study demonstrated excellent long-term outcomes in the low-risk patients treated with LAM after a short course of HBIG.