Liver transplantation in HBs antigen (HBsAg) carriers. Prevention of hepatitis B virus (HBV) recurrence by passive immunization.
Liver transplantation in HBs-antigen (HBsAg) positive allograft recipients is associated with a high risk of HBV recurrence some time after surgery. So far, results of measures to prevent recurrent HBV-infection by means of treatment with interferon, hepatitis B vaccination and short-term passive immunization with hepatitis B immunoglobulin (HBIg) or monoclonal antibody to HBsAg (anti-HBs) have been disappointing. In the present study the results of long-term, anti-HBs monitored passive immunization with HBIg is reported. In 23 HBsAg-positive liver transplant recipients an anti-HBs level of greater than or equal to 100 IU/l was maintained for 6 or 12 months, respectively. The rate of recurrent infection was found to be less than 20% under HBIg substitution, whereas 11 graft recipients with no or only short-term HBIg prophylaxis were reinfected by month 15 after transplantation. HBV recurrence was associated with chronic liver disease and recurrent cirrhosis in the allograft.
Müller
R
R
Abteilung für Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover, Federal Republic of Germany.
Gubernatis
G
G
Farle
M
M
Niehoff
G
G
Klein
H
H
Wittekind
C
C
Tusch
G
G
Lautz
H U
HU
Böker
K
K
Stangel
W
W
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000517:prevention & control*; D006514:Hepatitis B Surface Antigens / Q000032:analysis / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000032:analysis / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000276:immunology; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin