title: The long-term efficacy of combining nucleos(t)ide analog and low-dose hepatitis B immunoglobulin on post-transplant hepatitis B virus recurrence.
abstract: The aim of this study was to determine the long-term efficacy of nucleos(t)ide analog (NA) and low-dose hepatitis B immunoglobulin (HBIG) combination treatment for preventing post-transplant hepatitis B virus (HBV) recurrence.
  
  
  
  A total of 296 patients with HBV-associated liver disease who underwent liver transplantation (LT) were enrolled. A combination of a daily NA and low-dose HBIG was used after LT.
  
  
  
  The median follow-up period was 46 months. HBV recurrence occurred in eight patients. The cumulative probability of HBV recurrence at 1, 3, 5, and 7 years was 1%, 3%, 3%, and 4%, respectively. Seven were on lamivudine (LMV) or adefovir dipivoxil (ADV), or LMV and ADV and HBIG combination treatment and one entecavir (ETV) and HBIG. With Cox regression analysis, HBV recurrence was determined to be associated with the presence of hepatocellular cancer (HCC) prior to LT (HR: 12.3, P=.02). Overall, 44 patients died. Survival was significantly better in the ETV or tenofovir disoproxil fumarate (TDF) and HBIG group than the other group (P<.001).
  
  
  
  The combination of ETV or TDF and low-dose HBIG achieved a more favorable prophylaxis against HBV recurrence after LT. The presence of HCC prior to LT was associated with post-transplant HBV recurrence.
authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey. idilman@medicine.ankara.edu.tr.
authors.forename: Ramazan
authors.identifier: 0000-0001-8840-5472
authors.initials: R
authors.lastname: Idilman
authors.affiliation: Istanbul Bilim University Faculty of Medicine, Sisli Florence Nightingale Hospital Organ Transplantation Center, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akyildiz
authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Keskin
authors.affiliation: Istanbul Bilim University Faculty of Medicine, Sisli Florence Nightingale Hospital Organ Transplantation Center, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Gungor
authors.affiliation: Istanbul Bilim University Faculty of Medicine, Sisli Florence Nightingale Hospital Organ Transplantation Center, Istanbul, Turkey.
authors.forename: Tonguc U
authors.initials: TU
authors.lastname: Yilmaz
authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Kalkan
authors.affiliation: Istanbul Bilim University Faculty of Medicine, Sisli Florence Nightingale Hospital Organ Transplantation Center, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Dayangac
authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Kubilay
authors.initials: K
authors.lastname: Cinar
authors.affiliation: Department of Surgery, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Deniz
authors.initials: D
authors.lastname: Balci
authors.affiliation: Department of Surgery, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Hazinedaroglu
authors.affiliation: Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Yaman
authors.initials: Y
authors.lastname: Tokat
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D019259:Lamivudine / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D000068698:Tenofovir / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; D007155:Immunologic Factors; D063065:Organophosphonates; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000068698:Tenofovir; D000225:Adenine; C106812:adefovir dipivoxil; C045213:hepatitis B hyperimmune globulin
keywords: entecavir; hepatitis B immunoglobulin; liver transplantation; tenofovir disoproxil fumarate