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- W2035782309 abstract "Background: Low dose HBIG and nucleos(t)ides analogues (Lamivudine and Adefovir) used for the prevention of hepatitis B (HBV) recurrence after liver transplantation (LT) are associated with some risk of HBV recurrence and resistance to antivirals. Data on use of high genetic barrier drugs (Entecavir and Tenofovir) is lacking. Methods: The study cohort included patients with HBV cirrhosis and/or hepatocellular carcinoma who underwent living donor liver transplantation (LDLT). To prevent HBV recurrence, patients received 10,000 IU intravenous Hepatitis B immunoglobulin (HBIG) in anhepatic phase followed by 600-1000 U IM daily for 7 days, weekly for 3 weeks and then monthly to keep anti HBs levels above 100 mIU/ml for 1 year. Patients received nucleos(t)ide analogues for indefinite period. Patients were tested for HBsAg and HBV DNA every 6 months. Patients who died in first year post liver transplantation (no deaths were due to HBV recurrence) or who received Lamivudine/Adefovir (n=28) were not included in analysis. Results: Study cohort comprised of 99 patients (91 males), mean age 48.5±10.2 years, Child's score 8.8±2.3, MELD 19.7±7.1. Forty patients had hepatocellular carcinoma. All patients were positive for HBsAg, 24(24.2%) patients had HBV DNA >2000 IU (high risk of HBV recurrence) before transplantation. Post-transplant patients received Entecavir (n=66, 66.7%), Tenofovir (n=17, 17.1%), combination of Entecavir and Tenofovir (n=16, 16.1%). During a follow up of 28.7±17.7 months, two patients became HBsAg positive; of them one patient had positive HBV DNA as he was non-compliant to treatment. Conclusion: In a large cohort of LDLT recipients for HBV related disease, the use of low dose short term HBIG with high genetic barrier drugs can substantially decrease HBV recurrence even in high risk patients. However, a longer follow-up is needed to substantiate these results." @default.
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- W2035782309 date "2013-03-01" @default.
- W2035782309 modified "2023-10-17" @default.
- W2035782309 title "Low Dose Short term HBIG with High Genetic Barrier Antivirals is Associated with Minimal Risk of Hepatitis B Recurrence After Liver Transplantation" @default.
- W2035782309 doi "https://doi.org/10.1016/j.jceh.2013.03.009" @default.
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