title: [Prevention and treatment of hepatitis B recurrence after liver transplantation].
abstract: OBJECTIVE
  To investigate the effect of the regimen of lamivudine (LAM) combined with hepatitis B immunoglobulin (HBIG) in prevention and treatment of re-infection of hepatitis B virus (HBV) and recurrence of hepatitis B after orthotopic liver transplantation (OLT) for HBV related end stage liver disease.
  
  
  METHODS
  The clinical data of 183 adult liver transplantation patients who lived more than 6 months and were followed up for 14.6 months with complete data were studied retrospectively. According to the HBV prevention strategy, these recipients were divided into two groups: group of pure LAM (n = 106) and group of LAM plus intramuscular injection of low dose HBIG (n = 77).
  
  
  RESULTS
  The rate of HBsAg negative conversion 1 week after OLT of the LAM group was 82.10% (87/106), significantly lower than that of the LAM + HBIG group [94.81% (73/77), P = 0.010]. The rates of HBV reinfection, HB recurrence, and YMDD mutation of the lamivudine group were 16.98% (18/106), 11.32% (12/106), and 8.49% (9/106) respectively, all significantly higher than those of the LAM + HBIG group [6.49% (5/77), 2.60% (2/77), and 1.30% (1/77) respectively, P = 0.035, 0.028, and 0.035 respectively]. All the patients with YMDD mutation were treated with adefovir (ADF) with improvement. Analysis showed no obvious difference in the effect of LAM given intramuscularly or intravenously.
  
  
  CONCLUSIONS
  The protocol of combination of LAM and HBIG is highly effective, safe, and cost-effective in preventing the recurrence of HBV after OLT. YMDD mutation can be treated by ADF with satisfactory results.
authors.affiliation: Department II of Abdominal Surgery Affiliated Tumor Hospital of Guangzhou Medical College, Guangzhou 510095, China.
authors.forename: Xiang-liang
authors.initials: XL
authors.lastname: Zhang
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Zhu
authors.forename: Hui-juan
authors.initials: HJ
authors.lastname: Shi
authors.forename: Shu-zhong
authors.initials: SZ
authors.lastname: Cui
authors.forename: Yun-qiang
authors.initials: YQ
authors.lastname: Tang
authors.forename: Ming-chen
authors.initials: MC
authors.lastname: Ba
authors.forename: Jia-kang
authors.initials: JK
authors.lastname: Wang
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.forename: Qin
authors.initials: Q
authors.lastname: Lu
authors.forename: Hong-yu
authors.initials: HY
authors.lastname: Zhao
authors.forename: Yin-bing
authors.initials: YB
authors.lastname: Wu
authors.forename: Mei-lu
authors.initials: ML
authors.lastname: Li
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000209:etiology / Q000517:prevention & control*; D006515:Hepatitis B virus / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin