Hepatitis B virus and liver transplantation: concepts in antiviral prophylaxis.
Liver transplantation remains problematic in patients with end-stage liver disease secondary to chronic hepatitis B virus (HBV) infection. Recurrent hepatitis is almost universal in those patients who are HBV DNA-positive prior to transplantation. Prophylactic hepatitis B immune globulin can be given to reduce the rate of hepatitis B recurrence in patients who are HBV DNA-negative prior to transplantation. More recently novel antiviral drugs such as lamivudine or famciclovir have been used specifically to inhibit hepatitis B viral replication. However, the development of drug-resistant viral mutants have been observed. Further studies are needed to investigate these drugs more extensively, particularly to assess whether combination therapy may be a more effective means of controlling viral recurrence in patients transplanted for chronic HBV infection.
Grellier
L
L
Royal Free Hospital School of Medicine, London, UK.
Dusheiko
G M
GM
D000998:Antiviral Agents / Q000494:pharmacology; D006508:Hepatitis Antibodies / Q000627:therapeutic use; D006509:Hepatitis B / Q000628:therapy*; D006515:Hepatitis B virus; D006801:Humans; D007136:Immunoglobulins / Q000494:pharmacology; D007165:Immunosuppression Therapy; D007167:Immunotherapy; D016031:Liver Transplantation
D000998:Antiviral Agents; D006508:Hepatitis Antibodies; D007136:Immunoglobulins