title: New Perspectives on Treatment of Hepatitis B Before and After Liver Transplantation.
abstract: The hepatitis B virus (HBV) infects more than 260 million people globally, with increasing incidence, especially in developing countries. Despite antiviral therapies, HBV-related end-stage liver disease remains one of the most important indications for liver transplantation worldwide. Although new available treatments have improved the outcome of patients with both compensated and decompensated liver disease in some specific clinical settings as acute-on-chronic liver failure mortality is still high. Moreover, the incidence of HBV-related hepatocellular carcinoma (HCC) seems to be increasing and represents a major challenge for the transplant team. In the post-transplant setting, combination of anti-HBV immunoglobulins and oral nucleos(t)ides provided significant improvement on graft and patient survival. Furthermore, recent data suggested the possibility of personalized therapeutic algorithms based on pre and post-transplant viral and host risk factors. Finally, liver grafts from HBV core antibody (anti-HBc) positive or hepatitis B surface antigen (HBsAg) donors can be safely used in order to expand the donor pool, considering adequate allocation and tailored prophylaxis after LT. In this review we have focused on the evolution of antiviral therapy for HBV, highlighting useful information to aid the transplant hepatologist in clinical practice.
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zanetto
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferrarese
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bortoluzzi
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.affiliation: Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, Padova, Italy.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Russo
mesh_terms: D000465:Algorithms; D000998:Antiviral Agents / Q000627:therapeutic use; D046148:Donor Selection; D058625:End Stage Liver Disease / Q000209:etiology / Q000601:surgery / Q000628:therapy; D006510:Hepatitis B Antibodies / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000150:complications / Q000601:surgery* / Q000628:therapy*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects; D057285:Precision Medicine; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies