Reestablishment of active immunity against HBV graft reinfection after liver transplantation for HBV-related end stage liver disease.

Abstract

BACKGROUND:

The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.

METHOD:

Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.

RESULTS:

Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.

CONCLUSIONS:

Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.

• Authors: Shi-Chun Lu, Tao Jiang, Wei Lai, Yuan Liu, Jing Zhang, Dao-Bing Zeng, Chuan-Yun Li, Meng-Long Wang, Dong-Dong Lin, Yue Zhu, You-Ping Li, Ning Li
• Journal: Journal of immunology research (J Immunol Res) Vol. 2014 Pg. 764234 ( 2014) ISSN: 2314-7156 [Electronic] Egypt
• PMID: 25759834 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antiviral Agents
• Hepatitis B Antibodies
• Hepatitis B Antigens
• Hepatitis B Vaccines

Topics

• Adult
• Aged
• Antiviral Agents (administration & dosage)
• End Stage Liver Disease (complications, immunology, therapy)
• Feasibility Studies
• Female
• Follow-Up Studies
• Graft Survival
• Hepatitis B (complications, immunology, therapy)
• Hepatitis B Antibodies (blood)
• Hepatitis B Antigens (administration & dosage)
• Hepatitis B Vaccines
• Hepatitis B virus (immunology)
• Humans
• Immunity (drug effects)
• Liver Transplantation
• Male
• Middle Aged
• Prospective Studies
• Transplants (immunology, virology)
• Virus Activation (drug effects)