title: Outcomes of long-term administration of intravenous hepatitis B immunoglobulins for the prevention of recurrent hepatitis B after liver transplantation.
abstract: OBJECTIVE
  The aim of this study was to investigate the safety and efficacy of lifelong therapy with intravenous hepatitis B immunoglobulins (i.v. HBIg) to prevent recurrence of hepatitis B after orthotopic liver transplantation (OLT).
  
  
  METHODS
  This was a single-center retrospective study of the long-term outcome of 56 patients who were transplanted for active hepatitis B-related liver disease. In addition to i.v. HBIg, patients received antiviral therapy for at least 1 year.
  
  
  RESULTS
  1-, 5-, and 10-year survival rates were 95%, 82%, and 80%, respectively. None of the patients died due to hepatitis B virus (HBV)-related complications. In 3 patients (5%), a hepatitis B surface antigen (HBsAg)-negative status was not reached. All of these patients had a very high viral load at the time of OLT. HBsAg and HBV DNA reappeared in 6 patients (11%): In 1 patient, recurrence occurred 9 months after OLT while still under combination treatment with lamivudine, and 2 patients were temporarily treated abroad with intramuscular HBIg. Only 3 patients suffered from HBV recurrence while under monotherapy with i.v. HBIg. No serious side effects to i.v. HBIg were reported during this long-term follow-up.
  
  
  CONCLUSIONS
  Lifelong administration of i.v. HBIg is safe, and recurrence of HBV disease occurred only in a minority of the patients during long-term follow-up. Prognosis of HBV-related OLT with this therapy is excellent.
authors.affiliation: Department of Hepatology and Abdominal Transplantation Surgery, University Hospitals, Catholic University Leuven, Leuven, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Pauwelyn
authors.forename: D
authors.initials: D
authors.lastname: Cassiman
authors.forename: W
authors.initials: W
authors.lastname: Laleman
authors.forename: C
authors.initials: C
authors.lastname: Verslype
authors.forename: D
authors.initials: D
authors.lastname: Monbaliu
authors.forename: R
authors.initials: R
authors.lastname: Aerts
authors.forename: W
authors.initials: W
authors.lastname: Van Steenbergen
authors.forename: J
authors.initials: J
authors.lastname: Pirenne
authors.forename: F
authors.initials: F
authors.lastname: Nevens
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control* / Q000601:surgery; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D019562:Viral Load
chemical_list: D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin