title: Prophylaxis in HBV-infected liver transplant patients: end of the HBIG era?
abstract: Improvements in the outcomes of patients transplanted for hepatitis B virus (HBV) have been substantial in the past two decades. With current therapies, the vast majority of transplant recipients are protected against recurrent and/or progressive liver disease. Effective prophylactic therapies include hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues (NAs) and NA therapy alone (without HBIG). Definitions of recurrence in the setting of prophylaxis are evolving--persistence or reappearance of hepatitis B surface antigen in serum remains a marker of reinfection, but is not necessarily a marker of progressive hepatitis. The level of HBV DNA at the time of transplant remains the most consistent factor predicting risk of recurrent HBV. An individualized, rather than a "one size fits all", approach to prophylaxis that is based on risk of reinfection and/or risk of progressive disease, if reinfected, is the optimal means of insuring optimal graft survival for HBV-infected patients.
authors.forename: Norah
authors.initials: N
authors.lastname: Terrault
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000517:prevention & control*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D063065:Organophosphonates / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; C053001:adefovir; D000225:Adenine