Adherence to Lamivudine after an early withdrawal of hepatitis B immune globulin plays an important role in the long-term prevention of hepatitis B virus recurrence.
Lamivudine combined with hepatitis B immune globulin (HBIg) is the standard of care for preventing the recurrence hepatitis B virus after liver transplant. To determine the risk of hepatitis B virus (HBV) recurrence after early withdrawal of HBIg in patients receiving lamivudine maintenance therapy, 20 patients receiving a course of HBIg and lamivudine after transplantation and long-term maintenance therapy with lamivudine and 9 patients receiving HBIg and lamivudine indefinitely were analyzed. The survival rate was 90% after a mean follow-up of 83 months. The HBV recurrence rate was 14% with a mean period of 91 months free from HBV recurrence. Both groups had similar HBV recurrence rates, 15% for the combination and 11% for lamivudine alone. Four patients, 3 of whom were noncompliant with therapy, experienced posttransplant HBV recurrence. Patients who adhere to long-term prophylaxis with lamivudine after early withdrawal of HBIg have a low risk of HBV recurrence, similar to those who receive combination prophylaxis.
Buti
Maria
M
Hospital General Valle de Hebrón and CIBER EHD, Barcelona, Spain. mbuti@vhebronnet
Mas
Antoni
A
Prieto
Martin
M
Casafont
Fernando
F
González
Antonio
A
Miras
Manuel
M
Herrero
Jose Ignacio
JI
Jardi
Rosendo
R
Esteban
Rafael
R
D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000188:drug therapy* / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage* / Q000276:immunology; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013997:Time Factors
D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin