[Liver transplantation for chronic hepatitis B patients with lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin treatment].
OBJECTIVE
The aim of this study was designed to evaluate the outcomes of liver transplant recipients with chronic hepatitis B (CHB) receiving either lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin (HBIG) therapy.


METHODS
A total of 111 liver transplant recipients with CHB were divided not randomly into two groups according to the availability of HBIG before liver transplantation (LT). Thirty-two patients received lamivudine monotherapy (100 mg/d) and 79 patients received lamivudine (100 mg/d) combined with individualized low-dose HBIG (intramuscular administration) to maintain the titer of antibody to hepatitis B virus (HBV) surface antigen (anti-HBs) not less than 100 U/L. The patients were followed-up for a median time of 32 months (1 to 88 months).


RESULTS
In the lamivudine monotherapy group, 5 patients hepatitis B relapsed (3/5 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 7.1%, 14.3% and 17.9% and survival rates of 87.5%, 84.4% and 74.6%. In the lamivudine and HBIG combination therapy group, 2 patients hepatitis B relapsed (2/2 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 0, 1.8% and 5.7% (P < 0.01) and survival rates of 83.5%, 80.9% and 77.6% (P > 0.05).


CONCLUSIONS
Compared with lamivudine monotherapy, lamivudine combined with individualized low-dose HBIG can further reduce the recurrence risk of hepatitis B in liver transplant recipients. This combined therapy could be used as a rational strategy for prophylaxis of hepatitis B recurrence in such patients.
Jiao
Zuo-Yi
ZY
Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.
Yan
Lü-Nan
LN
Li
Bo
B
Zeng
Yong
Y
Wen
Tian-Fu
TF
Lu
Shi-Chun
SC
Zhao
Ji-Chun
JC
Wang
Wen-Tao
WT
Xu
Ming-Qing
MQ
Yang
Jia-Yin
JY
Li
Zhi-Hui
ZH
Ma
Yu-Kui
YK
Zhang
Zhong-Wei
ZW
Chen
Zhe-Yu
ZY
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000473:pathology / Q000517:prevention & control*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention
D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin