title: The role of entecavir in preventing hepatitis B recurrence after liver transplantation.
abstract: OBJECTIVE
  Although hepatitis B recurrence after liver transplantation has been reduced to 0%-10% since the application of the combination therapy of hepatitis B immunoglobulin (HBIG) and lamivudine, the viral mutation resistance of lamivudine is still an obstacle to the outcome of liver transplantation. Here we evaluate the role of entecavir in preventing hepatitis B recurrence after liver transplantation.
  
  
  METHODS
  Patients who received a liver transplantation for hepatitis B virus (HBV)-related end-stage liver disease in our center from March 2006 to December 2008 were enrolled in this study. All patients received entecavir (0.5 mg orally, daily) or lamivudine (100 mg orally, daily) together with a long-term low dosage of HBIG to prevent hepatitis B recurrence after transplantation. Serum viral markers (HBsAg, anti-HBs, HBeAg, anti-HBc and anti-HBe) and HBV-DNA level were determined.
  
  
  RESULTS
  Thirty patients receiving entecavir and 90 patients receiving lamivudine were matched with the same age and sex in both groups. No reinfection of hepatitis B was detected in the entecavir group. The hepatitis B surface antigen of patients in the entecavir group became negative within one week and no patient had any adverse effect relating to entecavir. There was no difference in the cumulative survival rate between the entecavir group and the lamivudine group (P > 0.05).
  
  
  CONCLUSIONS
  This study shows that entecavir combined with low dosages of HBIG is effective and safe in preventing hepatitis B recurrence after liver transplantation, but its long-term effect is still under investigation and a large-sample study will be carried out in the future.
authors.affiliation: Department of Organ Transplantation, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zhi Feng
authors.initials: ZF
authors.lastname: Xi
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xia
authors.forename: Jian Jun
authors.initials: JJ
authors.lastname: Zhang
authors.forename: Xiao Song
authors.initials: XS
authors.lastname: Chen
authors.forename: Long Zhi
authors.initials: LZ
authors.lastname: Han
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Cong Huan
authors.initials: CH
authors.lastname: Shen
authors.forename: Yi
authors.initials: Y
authors.lastname: Luo
authors.forename: Tian Yu
authors.initials: TY
authors.lastname: Xin
authors.forename: Si Yue
authors.initials: SY
authors.lastname: Wang
authors.forename: De Kai
authors.initials: DK
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006508:Hepatitis Antibodies / Q000008:administration & dosage; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D019259:Lamivudine / Q000008:administration & dosage; D017093:Liver Failure / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality / Q000821:virology; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage; D055502:Secondary Prevention
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006508:Hepatitis Antibodies; D006514:Hepatitis B Surface Antigens; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; C413685:entecavir; D006147:Guanine