Outcome of various treatments for posttransplant hepatitis B virus recurrence.

Abstract

BACKGROUND:

Currently, no treatment guidelines are available for posttransplant hepatitis B virus (HBV) recurrence. We retrospectively evaluated the rate of clearance of hepatitis B surface antigen (HBsAg) from serum according to various treatment regimens in two large Korean liver transplantation centers.

METHODS:

Between 1996 and 2008, HBV recurred in 59 patients among 933 HBV liver recipients (6.3 %). Patients with HBV recurrence were divided into four groups according to their treatment: group L (lamivudine-based therapy n = 21) and group N [new nucleos(t)ide analogue (NA)-based therapy, n = 38]. Intravenous hepatitis B immunoglobulin (ivHBIG) had been simultaneously administered to 10 patients in group L and 26 patients in group N. The mean posttransplant follow-up duration and time to HBV recurrence were 69 (14-152) months and 37 (3-120) months.

RESULTS:

Overall, 22 patients (37.3 %) showed seronegative conversion of HBsAg for a median 8 months after treatment (range 1-15 months). The seroclearance rate was significantly higher in group N (n = 20, 52.6 %) than in group L (n = 2, 9.5 %) (p < 0.000). The time to seroconversion did not differ between group L (7 months, range 5-16) and group N (7 months, range 1-15) (p = 0.428). Subgroup analysis showed that the HBsAg seroconversion rate was much higher for patients given combined ivHBIG and new NAs (15/26 patients, 58.0 %) than the others (p = 0.006).

CONCLUSIONS:

Seroclearance of HBsAg could be achieved using new NAs in half of the patients after posttransplant HBV recurrence. Combined ivHBIG may add a synergistic effect to new NAs for clearing HBsAg.

• Authors: Nam-Joon Yi, Kwang-Woong Lee, Sun-Young Kong, Kyoung-Un Park, Kyoung-Bun Lee, Geun Hong, Sung-Sik Han, Sang-Jae Park, Kyung-Suk Suh
• Journal: World journal of surgery (World J Surg) Vol. 37 Issue 4 Pg. 812-9 (Apr 2013) ISSN: 1432-2323 [Electronic] United States
• PMID: 23344522 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Antiviral Agents
• Biomarkers
• Hepatitis B Surface Antigens
• Immunoglobulins, Intravenous
• Immunologic Factors
• Organophosphonates
• Lamivudine
• entecavir
• Guanine
• adefovir
• Adenine

Topics

• Adenine (analogs & derivatives, therapeutic use)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antiviral Agents (therapeutic use)
• Biomarkers (blood)
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Guanine (analogs & derivatives, therapeutic use)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B, Chronic (blood, diagnosis, drug therapy, surgery)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Lamivudine (therapeutic use)
• Liver Transplantation
• Male
• Middle Aged
• Organophosphonates (therapeutic use)
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Young Adult