title: Posttransplantation hepatitis B prophylaxis with combination oral nucleoside and nucleotide analog therapy.
abstract: Liver transplant recipients are at risk of developing recurrent hepatitis B after liver transplantation for hepatitis B virus (HBV)-related liver disease. We evaluated the efficacy of a new hepatitis B prophylaxis regimen involving conversion from at least 12 months of HBIg with lamivudine to combination therapy with an oral nucleoside and nucleotide analog. Between June 2008 and May 2010, a total of 61 liver transplant recipients were converted to a combination of a nucleoside and nucleotide analog. The mean (±standard deviation) follow-up time after conversion was 15.0 (±6.1) months. Recurrent HBV occurred in two (3.3%) patients at 3.1 and 16.6 months after HBIg cessation. The overall person time incidence rate for HBV recurrence after HBIg cessation was 2.7 cases per 100 person-years. The estimate of HBV recurrence was 1.7% at 1 year after HBIg cessation. HBIg cessation a minimum of 12 months after liver transplantation with subsequent combination therapy with a nucleoside and nucleotide analog provides effective prophylaxis against recurrent HBV infection. The clinical implications of HBsAg detection without clinical, biochemical or molecular manifestations of recurrent hepatitis B require further study.
authors.affiliation: Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, CA, USA. ssaab@mednet.ucla.edu
authors.forename: S
authors.initials: S
authors.lastname: Saab
authors.forename: S
authors.initials: S
authors.lastname: Desai
authors.forename: D
authors.initials: D
authors.lastname: Tsaoi
authors.forename: F
authors.initials: F
authors.lastname: Durazo
authors.forename: S
authors.initials: S
authors.lastname: Han
authors.forename: A
authors.initials: A
authors.lastname: McClune
authors.forename: C
authors.initials: C
authors.lastname: Holt
authors.forename: D
authors.initials: D
authors.lastname: Farmer
authors.forename: L
authors.initials: L
authors.lastname: Goldstein
authors.forename: R W
authors.initials: RW
authors.lastname: Busuttil
mesh_terms: D000284:Administration, Oral; D004359:Drug Therapy, Combination; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control* / Q000821:virology; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009705:Nucleosides / Q000627:therapeutic use*; D009711:Nucleotides / Q000627:therapeutic use*; D011183:Postoperative Complications; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D009705:Nucleosides; D009711:Nucleotides