Hepatitis B immunoglobulins and/or lamivudine for preventing hepatitis B recurrence after liver transplantation: A systematic review
Article first published online: 29 OCT 2009
© 2010 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 25, Issue 5, pages 872–879, May 2010
How to Cite
Chen, J., Yi, L., Jia, J. D., Ma, H. and You, H. (2010), Hepatitis B immunoglobulins and/or lamivudine for preventing hepatitis B recurrence after liver transplantation: A systematic review. Journal of Gastroenterology and Hepatology, 25: 872–879. doi: 10.1111/j.1440-1746.2009.06151.x
- Issue published online: 28 APR 2010
- Article first published online: 29 OCT 2009
- Accepted for publication 9 October 2009.
- hepatitis B immunoglobulins;
- hepatitis B recurrence;
- liver transplantation;
- systematic review
Background: Currently, hepatitis B immunoglobulins (HBIg) and/or lamivudine have become the main options for prevention of hepatitis B recurrence after liver transplantation.
Aim: To assess the benefits of HBIg and/or lamivudine for prevention of hepatitis B recurrence after liver transplantation.
Methods: We conducted a search of electronic databases and a manual search of bibliographical lists of relevant articles. All randomized clinical trials and non-randomized studies that meet the pre-specified criteria were included. However, results of non-randomized studies were reported under ‘exploratory analyses’ in the result section. The outcome measure was hepatitis B recurrence.
Results: Two randomized and 44 non-randomized studies were included. Meta-analysis of two randomized studies shows one week HBIg combined with lamivudine regimen had equivalent effect compared with long-term high-dose HBIg regimen for preventing hepatitis B recurrence (RR 1.23; 95% CI 0.38–4.03; P = 0.73). For 44 non-randomized studies, only qualitative systematic review was performed. With long-term HBIg prophylaxis, hepatitis B recurrence rate ranged from 3.7% to 65%; with lamivudine prophylaxis, hepatitis B recurrence rate varied from 3.8% to 40.4%; Long-term high-dose HBIg plus lamivudine prophylaxis can reduce the risk of HBV recurrence to less than 10%.
Conclusions: Long-term HBIg prophylaxis or lamivudine prophylaxis can reduce the risk for hepatitis B virus recurrence. Long-term high-dose HBIg combined with lamivudine can further reduce HBV recurrence to less than 10%.