title: Short-term high-dose followed by long-term low-dose hepatitis B immunoglobulin and lamivudine therapy prevented recurrent hepatitis B after liver transplantation.
abstract: Hepatitis B immunoglobulin (HBIg) and lamivudine combination has been accepted as the best way to control hepatitis B recurrence after liver transplantation. However, the optimal dose of HBIg and the target titer of hepatitis B surface antibody (HBsAb) remain unclear. We report our satisfactory experience with high-dose HBIg in the early period followed by low-dose HBIg with lamivudine. Subjects comprised five patients with fulminant hepatitis (FH) and 18 patients with liver cirrhosis (LC) who underwent liver transplantation. HBIg at a dosage of 200 IU/kg per day was administered for one week postoperatively. Thereafter, HBIg was administered only for HBsAb titer <100 IU/L. After six months, HBIg was withdrawn in FH and administered in LC only for HBsAb titer <10 IU/L. Lamivudine was administered to two FH and all LC cases. Although two patients with LC showed transient hepatitis B surface antigen (HBsAg) recurrence, all patients remained HBsAg-negative at the final follow-up date. This method allows reliable and cost-effective control of hepatitis B recurrence.
authors.affiliation: Department of Gastroenterology, Transplant and Surgical Oncology, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Japan. akitaka@md.okayama-u.ac.jp
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.forename: Takahito
authors.initials: T
authors.lastname: Yagi
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sadamori
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsukawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Susumu
authors.initials: S
authors.lastname: Shinoura
authors.forename: Yuuzou
authors.initials: Y
authors.lastname: Umeda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Ryou
authors.initials: R
authors.lastname: Terada
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kobashi
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
mesh_terms: D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control* / Q000601:surgery / Q000821:virology; D006511:Hepatitis B Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000276:immunology* / Q000627:therapeutic use*; D007167:Immunotherapy; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000276:immunology; D055502:Secondary Prevention; D013997:Time Factors
chemical_list: D006511:Hepatitis B Antigens; D007136:Immunoglobulins; D019259:Lamivudine