title: Long-term outcomes of entecavir monotherapy for chronic hepatitis B after liver transplantation: Results up to 8 years.
abstract: Long-term antiviral prophylaxis is required to prevent hepatitis B recurrence for patients with chronic hepatitis B after liver transplantation. We determined the long-term outcome of 265 consecutive chronic hepatitis B liver transplant recipients treated with entecavir monotherapy without hepatitis B immune globulin. Viral serology, viral load, and liver biochemistry were performed at regular intervals during follow-up. The median duration of follow-up was 59 months. The cumulative rates of hepatitis B surface antigen (HBsAg) seroclearance were 90% and 95% at 1 and 5 years, respectively. At 1, 3, 5, and 8 years, 85%, 88%, 87.0%, and 92% were negative for HBsAg, respectively, and 95%, 99%, 100%, and 100% had undetectable hepatitis B virus (HBV) DNA, respectively. Fourteen patients remained persistently positive for HBsAg, all of whom had undetectable HBV DNA. There was no significant difference in liver stiffness for those who remained HBsAg-positive compared to those who achieved HBsAg seroclearance (5.5 versus 5.2 kPa, respectively; P = 0.52). The overall 9-year survival was 85%. There were 37 deaths during the follow-up period, of which none were due to hepatitis B recurrence.
  
  
  
  Long-term entecavir monotherapy is highly effective at preventing HBV reactivation after liver transplantation for chronic hepatitis B, with a durable HBsAg seroclearance rate of 92%, an undetectable HBV DNA rate of 100% at 8 years, and excellent long-term survival of 85% at 9 years. (Hepatology 2017;66:1036-1044).
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Gastroenterology and Hepatology, Department of Medicine, The University of Hong Kong, Hong Kong.|State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
authors.forename: James
authors.identifier: 0000-0002-1286-8902
authors.initials: J
authors.lastname: Fung
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Wong
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Kenneth
authors.identifier: 0000-0001-7921-3807
authors.initials: K
authors.lastname: Chok
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Albert Chi-Yan
authors.initials: AC
authors.lastname: Chan
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Tan-To
authors.initials: TT
authors.lastname: Cheung
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Jeff Wing-Chiu
authors.initials: JW
authors.lastname: Dai
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Sui-Ling
authors.initials: SL
authors.lastname: Sin
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Ka-Wing
authors.initials: KW
authors.lastname: Ma
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Kelvin
authors.initials: K
authors.lastname: Ng
authors.affiliation: Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Kevin Tak-Pan
authors.initials: KT
authors.lastname: Ng
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, The University of Hong Kong, Hong Kong.|State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
authors.forename: Wai-Kay
authors.identifier: 0000-0002-9012-313X
authors.initials: WK
authors.lastname: Seto
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, The University of Hong Kong, Hong Kong.|State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Lai
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, The University of Hong Kong, Hong Kong.|State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
authors.forename: Man-Fung
authors.identifier: 0000-0001-7985-7725
authors.initials: MF
authors.lastname: Yuen
authors.affiliation: The Liver Transplant Center, Queen Mary Hospital, Hong Kong.|State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.|Division of Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors.forename: Chung-Mau
authors.identifier: 0000-0002-3964-5995
authors.initials: CM
authors.lastname: Lo
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000601:surgery / Q000821:virology; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006514:Hepatitis B Surface Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000401:mortality / Q000821:virology; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; C413685:entecavir; D006147:Guanine