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.
Abteilung für Gastroenterologie und Hepatologie, Medizinische Hochschule Hannover, Federal Republic of Germany.
R
R
Müller
G
G
Gubernatis
M
M
Farle
G
G
Niehoff
H
H
Klein
C
C
Wittekind
G
G
Tusch
H U
HU
Lautz
K
K
Böker
W
W
Stangel
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