Liver transplantation for chronic hepatitis B patients with lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin treatment.
- Author:
Zuo-Yi JIAO
1
;
Lü-Nan YAN
;
Bo LI
;
Yong ZENG
;
Tian-Fu WEN
;
Shi-Chun LU
;
Ji-Chun ZHAO
;
Wen-Tao WANG
;
Ming-Qing XU
;
Jia-Yin YANG
;
Zhi-Hui LI
;
Yu-Kui MA
;
Zhong-Wei ZHANG
;
Zhe-Yu CHEN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Antiviral Agents; therapeutic use; Drug Therapy, Combination; Female; Follow-Up Studies; Hepatitis B; pathology; prevention & control; Hepatitis B virus; immunology; Humans; Immunoglobulins; therapeutic use; Lamivudine; therapeutic use; Liver Transplantation; Male; Middle Aged; Secondary Prevention
- From: Chinese Journal of Hepatology 2007;15(11):804-808
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVEThe aim of this study was designed to evaluate the outcomes of liver transplant recipients with chronic hepatitis B (CHB) receiving either lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin (HBIG) therapy.
METHODSA total of 111 liver transplant recipients with CHB were divided not randomly into two groups according to the availability of HBIG before liver transplantation (LT). Thirty-two patients received lamivudine monotherapy (100 mg/d) and 79 patients received lamivudine (100 mg/d) combined with individualized low-dose HBIG (intramuscular administration) to maintain the titer of antibody to hepatitis B virus (HBV) surface antigen (anti-HBs) not less than 100 U/L. The patients were followed-up for a median time of 32 months (1 to 88 months).
RESULTSIn the lamivudine monotherapy group, 5 patients hepatitis B relapsed (3/5 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 7.1%, 14.3% and 17.9% and survival rates of 87.5%, 84.4% and 74.6%. In the lamivudine and HBIG combination therapy group, 2 patients hepatitis B relapsed (2/2 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 0, 1.8% and 5.7% (P < 0.01) and survival rates of 83.5%, 80.9% and 77.6% (P > 0.05).
CONCLUSIONSCompared with lamivudine monotherapy, lamivudine combined with individualized low-dose HBIG can further reduce the recurrence risk of hepatitis B in liver transplant recipients. This combined therapy could be used as a rational strategy for prophylaxis of hepatitis B recurrence in such patients.