13 November 2018 : Original article
Recurrence of Hepatitis B Infection in Liver Transplant Patients Receiving Long-Term Hepatitis B Immunoglobulin Prophylaxis
Susanne Beckebaum1ABCDEF*, Kerstin Herzer2BE, Artur Bauhofer3ADE, William Gelson4BE, Paolo De Simone5BE, Robert de Man6BE, Cornelius Engelmann7BE, Beat Müllhaupt8BE, Julien Vionnet9BE, Mauro Salizzoni10BE, Riccardo Volpes11BE, Giorgio Ercolani12BE, Luciano De Carlis13BE, Paolo Angeli14BE, Patrizia Burra14BE, Jean-François Dufour15BE, Massimo Rossi16BE, Umberto Cillo17BE, Ulf Neumann18BE, Lutz Fischer19BE, Gabriele Niemann3DE, Luca Toti20BE, Guiseppe Tisone20BEDOI: 10.12659/AOT.910176
Ann Transplant 2018; 23:789-801
Abstract
BACKGROUND: Long-term real-world data are relatively sparse regarding recurrence of chronic hepatitis B virus (HBV) infection after liver transplantation using hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogue (NUC) prophylaxis.
MATERIAL AND METHODS: Data from 371 adults transplanted for HBV-related disease at 20 European centers and given HBIg for ³12 months ± NUC therapy were analyzed retrospectively.
RESULTS: HBIg comprised Hepatect® (iv HBIgB; n=299), subcutaneous Zutectra® (sc HBIg, n=236), and other HBIg preparations (n=130); 93.5% received NUC therapy. Mean follow-up was 6.8±3.5 years. The primary efficacy variable, freedom from HBV recurrence, occurred in 95.7% of patients (95% CI [93.1%, 97.5%]). The observed incidence of recurrence was 16/371 (4.3%) (annual rate 0.65%); 5/16 patients with recurrence had discontinued HBIg and 7/16 had anti-HBs <100 IU/l. Excluding these 7 patients, the HBV recurrence rate was 2.4%. The recurrence rate while on HBIg therapy was 1 per 2069 months. In patients who discontinued HBIg, risk of HBV recurrence versus sc HBIg users was increased by 5.2-fold (1 per 1 603 versus 1 per 8379 treatment months). The annual rate of HBV-related hepatocellular carcinoma (HCC) recurrence was 1.7%.
CONCLUSIONS: These results support the long-term use of HBIg with NUC therapy as an effective management strategy to minimize risk of HBV recurrence and virus-related complications after liver transplantation.
Keywords: Hepatitis B virus, Liver Transplantation, Recurrence
In Press
Original article
Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver TransplantationAnn Transplant In Press; DOI: 10.12659/AOT.947772
Original article
Effects of Donor-Recipient Race Matching on Kidney Transplant SurvivalAnn Transplant In Press; DOI: 10.12659/AOT.947720
Most Viewed Current Articles
03 Jan 2023 : Original article 7,006
Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...DOI :10.12659/AOT.938467
Ann Transplant 2023; 28:e938467
15 Aug 2023 : Review article 6,993
Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ TransplantationDOI :10.12659/AOT.939750
Ann Transplant 2023; 28:e939750
16 May 2023 : Original article 6,746
Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...DOI :10.12659/AOT.939258
Ann Transplant 2023; 28:e939258
28 May 2024 : Original article 6,170
Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...DOI :10.12659/AOT.943281
Ann Transplant 2024; 29:e943281