title: The role of HBIg as hepatitis B reinfection prophylaxis following liver transplantation.
abstract: BACKGROUND
  Without adequate prophylaxis, liver transplantation (LTx) is frequently followed by hepatitis B virus (HBV) reinfection, which results in rapidly progressing liver disease and significantly decreased overall survival. In the last two decades, significant progress has been made in the prophylaxis and treatment of HBV.
  
  
  CONCLUSIONS
  We present an overview of different protocols and regimens used for prophylaxis of HBV reinfection after LTx and describe the protocol implemented at our center. Following LTx, HBV reinfection can be effectively prevented by administration of anti-hepatitis B immunoglobulin (HBIg) alone or more recently in combination with antiviral nucleoside/nucleotide analogs (NUCs). Several studies reported good results with the use of HBIg alone, but combination treatment with HBIg and NUCs has proven to be a superior prophylactic regimen for HBV recurrence. At present, combination therapy (HBIg and a nucleoside or nucleotide analog) is the gold standard used in many transplantation centers. This preventive regimen reduces the risk of a recurrence of HBV infection and thereby the need for re-transplantation. Future and ongoing studies will show how long HBIg must be given after transplantation, especially when used in combination with potent antivirals, such as entecavir or tenofovir.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. arianeb_mehrabi@med.uni-heidelberg.de
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.forename: Majid
authors.initials: M
authors.lastname: Esmaeilzadeh
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Fonouni
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Hafezi
authors.forename: Nuh N
authors.initials: NN
authors.lastname: Rahbari
authors.forename: Mohammad
authors.initials: M
authors.lastname: Golriz
authors.forename: Ali
authors.initials: A
authors.lastname: Majlesara
authors.forename: Morva Tahmasbi
authors.initials: MT
authors.lastname: Rad
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.forename: Tom M
authors.initials: TM
authors.lastname: Ganten
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006515:Hepatitis B virus / Q000187:drug effects; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage*; D019259:Lamivudine / Q000008:administration & dosage; D017093:Liver Failure / Q000175:diagnosis / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology / Q000379:methods*; D008297:Male; D011182:Postoperative Care; D011379:Prognosis; D018570:Risk Assessment; D055502:Secondary Prevention; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; D019259:Lamivudine; C045213:hepatitis B hyperimmune globulin