title: Reestablishment of active immunity against HBV graft reinfection after liver transplantation for HBV-related end stage liver disease.
abstract: BACKGROUND
  The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.
  
  
  METHODS
  Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.
  
  
  RESULTS
  Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.
  
  
  CONCLUSIONS
  Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China ; Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
authors.forename: Shi-Chun
authors.identifier: 0000-0003-3278-0534
authors.initials: SC
authors.lastname: Lu
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Tao
authors.identifier: 0000-0003-2587-3521
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of General Surgery, Chengdu First People's Hospital, Sichuan 610041, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lai
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Dao-Bing
authors.initials: DB
authors.lastname: Zeng
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Chuan-Yun
authors.initials: CY
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Meng-Long
authors.initials: ML
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Dong-Dong
authors.initials: DD
authors.lastname: Lin
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Key Laboratory of Transplant Engineering and Immunology of Health Ministry, West China Hospital, Sichuan University, Chengdu, Sichuan 610044, China.
authors.forename: You-Ping
authors.initials: YP
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D058625:End Stage Liver Disease / Q000150:complications / Q000276:immunology* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006509:Hepatitis B / Q000150:complications / Q000276:immunology* / Q000628:therapy; D006510:Hepatitis B Antibodies / Q000097:blood; D006511:Hepatitis B Antigens / Q000008:administration & dosage*; D017325:Hepatitis B Vaccines; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D007109:Immunity / Q000187:drug effects; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019737:Transplants / Q000276:immunology / Q000821:virology; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D017325:Hepatitis B Vaccines