title: Clinical-pathological analysis of hepatitis B virus recurrence after liver transplantation in Chinese patients.
abstract: OBJECTIVE
  Liver transplantation (LT) for hepatitis B virus (HBV)-related disease can be complicated by HBV recurrence. The aim of this study was to evaluate the risk factors, prophylaxis treatment, and histological characteristics of HBV recurrence after LT when using long-term, low-dose hepatitis B immunoglobulin (HBIG) plus nucleoside analog (lamivudine [LAM] or entecavir [ETV]).
  
  
  METHODS
  Retrospective data from 253 adult LT patients using long-term, low-dose HBIG plus nucleoside analog after LT, for a mean treatment duration of 1-72 months, were collected from a single center in Beijing, China. Univariate analyses were conducted to determine the association among gender, age, hepatocellular carcinoma, hepatitis B e antigen-positive status, HBV-DNA level and tyrosine-methionine-aspartate-aspartate (YMDD) mutations on HBV recurrence in these patients.
  
  
  RESULTS
  Overall, the HBV recurrence rate was 6.32% (16/253). There was no significant difference in the survival rate between the HBV recurrence and non-recurrence groups. Risk factors for HBV recurrence were: hepatitis B e antigen positivity, HBV-DNA > 10(5) copies/mL, hepatocellular carcinoma, and YMDD mutation. Sixteen patients receiving LAM had HBV recurrence (16/169; mean treatment duration: 61.8 ± 18.3 months). No HBV recurrence occurred in patients receiving ETV after LT (0/84; mean treatment duration: 57.1 ± 15.9 months). Differences in rate of mortality and HBV recurrence were not significant between the two groups.
  
  
  CONCLUSIONS
  LT is an effective treatment for HBV-related end-stage liver disease. The combination of ETV and intramuscular HBIG for HBV recurrence prophylaxis after LT was more effective than LAM, especially in Chinese patients with HBV recurrence risk factors.
authors.affiliation: Medical School of Chinese PLA, Beijing, China; Department of Infectious Diseases, 302 Military Hospital, Beijing, China.
authors.forename: Yin-Jie
authors.initials: YJ
authors.lastname: Gao
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Jin
authors.forename: Fan-Ping
authors.initials: FP
authors.lastname: Meng
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: Ma
authors.forename: Zhen-Wen
authors.initials: ZW
authors.lastname: Liu
authors.forename: Hai-Bin
authors.initials: HB
authors.lastname: Su
authors.forename: Jing-Min
authors.initials: JM
authors.lastname: Zhao
authors.forename: Han-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents; D001224:Aspartic Acid / Q000235:genetics; D006528:Carcinoma, Hepatocellular; D002681:China / Q000453:epidemiology; D004279:DNA, Viral; D004359:Drug Therapy, Combination; D058625:End Stage Liver Disease / Q000209:etiology / Q000628:therapy*; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control*; D006513:Hepatitis B e Antigens; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage; D019259:Lamivudine / Q000008:administration & dosage; D008113:Liver Neoplasms; D016031:Liver Transplantation; D008297:Male; D008715:Methionine / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D012737:Sex Factors; D014443:Tyrosine / Q000235:genetics
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D007136:Immunoglobulins; D019259:Lamivudine; D001224:Aspartic Acid; D014443:Tyrosine; C413685:entecavir; D006147:Guanine; D008715:Methionine; C045213:hepatitis B hyperimmune globulin
keywords: entecavir; hepatitis B; lamivudine; liver transplantation; recurrence