Prophylaxis of recurrent hepatitis B in Chinese patients after liver transplantation using lamivudine combined with hepatitis B immune globulin according to the titer of antibody to hepatitis B surface antigen.
OBJECTIVE
We sought to determine the outcomes of long-term use of lamivudine combined with hepatitis B immune globulin according to the titer of antibody to hepatitis B surface antigen in preventing recurrent hepatitis B in Chinese patients after liver transplantation.


METHODS
Eighty-five patients with detectable hepatitis B envelope antigen in serum before liver transplantation were retrospectively enrolled in the study. Twenty-eight patients used lamivudine monotherapy as a control group. Fifty-seven patients used lamivudine combined with hepatitis B immune globulin therapy according to the titer of antibody to hepatitis B surface antigen.


RESULTS
In the lamivudine monotherapy group, seven patients had recurrent hepatitis B after transplantation, with 1-, 2-, and 3-year recurrence rates of 10.70%, 21.90%, and 25.8%, respectively. In the combination therapy group, three patients had recurrent hepatitis B after transplantation, with 1-, 2-, and 3-year recurrence rates of 0.00%, 5.50%, and 13.40% (P = .03). YMDD mutants were detected in 6 of the 10 patients with recurrent hepatitis B. HBV-DNA load before transplantation was significantly associated with recurrent hepatitis B after transplantation in the overall patients (P = .04).


CONCLUSIONS
Long-term use of lamivudine combined with hepatitis B immune globulin, according to the titer of antibody to hepatitis B surface antigen was efficacious and cost effective to prevent recurrent hepatitis B in Chinese patients after liver transplantation.
Jiao
Z-Y
ZY
West China Liver Transplantation Center, Guoxuexiang no. 37, Chengdu, Sichuan 610041, China.
Jiao
Z
Z
D000328:Adult; D002681:China; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology* / Q000601:surgery; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000276:immunology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis
D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D019259:Lamivudine