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The long-term efficacy of combining nucleos(t)ide analog and low-dose hepatitis B immunoglobulin on post-transplant hepatitis B virus recurrence.
- Source :
-
Clinical transplantation [Clin Transplant] 2016 Oct; Vol. 30 (10), pp. 1216-1221. Date of Electronic Publication: 2016 Aug 08. - Publication Year :
- 2016
-
Abstract
- Background: The aim of this study was to determine the long-term efficacy of nucleos(t)ide analog (NA) and low-dose hepatitis B immunoglobulin (HBIG) combination treatment for preventing post-transplant hepatitis B virus (HBV) recurrence.<br />Methods: A total of 296 patients with HBV-associated liver disease who underwent liver transplantation (LT) were enrolled. A combination of a daily NA and low-dose HBIG was used after LT.<br />Results: The median follow-up period was 46 months. HBV recurrence occurred in eight patients. The cumulative probability of HBV recurrence at 1, 3, 5, and 7 years was 1%, 3%, 3%, and 4%, respectively. Seven were on lamivudine (LMV) or adefovir dipivoxil (ADV), or LMV and ADV and HBIG combination treatment and one entecavir (ETV) and HBIG. With Cox regression analysis, HBV recurrence was determined to be associated with the presence of hepatocellular cancer (HCC) prior to LT (HR: 12.3, P=.02). Overall, 44 patients died. Survival was significantly better in the ETV or tenofovir disoproxil fumarate (TDF) and HBIG group than the other group (P<.001).<br />Conclusion: The combination of ETV or TDF and low-dose HBIG achieved a more favorable prophylaxis against HBV recurrence after LT. The presence of HCC prior to LT was associated with post-transplant HBV recurrence.<br /> (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adenine analogs & derivatives
Adenine therapeutic use
Administration, Oral
Adult
Aged
Drug Administration Schedule
Drug Therapy, Combination
Female
Follow-Up Studies
Guanine analogs & derivatives
Guanine therapeutic use
Hepatitis B, Chronic etiology
Humans
Kaplan-Meier Estimate
Lamivudine therapeutic use
Male
Middle Aged
Organophosphonates therapeutic use
Proportional Hazards Models
Recurrence
Retrospective Studies
Tenofovir therapeutic use
Treatment Outcome
Antiviral Agents therapeutic use
Hepatitis B, Chronic prevention & control
Immunoglobulins therapeutic use
Immunologic Factors therapeutic use
Liver Transplantation
Postoperative Complications prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1399-0012
- Volume :
- 30
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 27409074
- Full Text :
- https://doi.org/10.1111/ctr.12804