title: [Hepatitis B recurrence after liver transplantation: efficacy and safety of intramuscular anti-hepatitis B immunoglobulins].
abstract: Ten to 25% of all patients undergoing liver transplantation (LT) have hepatitis B. LT outcome depends on the prevention of hepatitis B recurrence. In absence of prophylaxis the spontaneous risk for hepatitis B virus (HBV) reinfection is up to 75% but the major advances which have been made in prophylaxis in the last 15 years permit today the control of post-LT hepatitis B in more than 90% of patients. Anti-hepatitis B virus specific immunoglobulins (HBIG) play a major role in prophylaxis, in mono-therapy in non-replicating patients and combined with antivirals (lamivudine and/or adefovir-dipivoxil) in replicating subjects. In absence of standardized schedules of HBIG administration, the prevalent approach is the use of high doses (40 000-80 000 IU) of intravenous HBIG in the immediate peri-operative period (induction phase) and the administration of a monthly dose, fixed or on demand, of intravenous (6 000-10 000 IU) or intramuscular (2 000-4 000 IU) HBIG in the long-term (maintenance). In stable patients the combined-prophylaxis with antivirals permits a HBIG saving, in particular in on demand protocols; in this setting intramuscular HBIG are effective and safe in the maintenance phase.
authors.affiliation: Divisione di Gastro-Epatologia, Ospedale San Giovanni Battista, Corso Bramante 88, 10125 Torino. alfredomarzano@yahoo.it
authors.forename: A
authors.initials: A
authors.lastname: Marzano
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D006509:Hepatitis B / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007273:Injections, Intramuscular; D016031:Liver Transplantation; D055502:Secondary Prevention
chemical_list: D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin