Etiology and prevention of hepatitis B virus reinfection after liver transplantation
- VernacularTitle:肝移植术后乙型肝炎病毒再感染的病因与防治
- Author:
Xianjie SHI
;
Ningxin ZHOU
;
Wenbin JI
- Publication Type:Journal Article
- Keywords:
liver transplantation;
hepatitis B virus(HBV);
reinfection
- From:
Medical Journal of Chinese People's Liberation Army
1981;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the etiology and clinical prevention regime for hepatitis B virus reinfection in patients after orthotopic liver transplantation. Methods One hundred and twenty eight orthotopic liver transplantation recipients with hepatitis B virus related end-stage liver diseases were analyzed retrospectively. The patients' primary diseases included chronic fulminant hepatitis B, end-stage liver cirrhosis and liver carcinoma. All the patients were given lamivudine pre-transplantation to prevent hepatitis B virus reinfection. Single lamivudine was administered post-transplantation in 3 cases; lamivudine combined with hepatitis B immunoglobulin were given in 125 cases. Adefovir dipivoxil was administered to the patients with hepatitis B virus reinfection. All the patients were followed-up for 3～48 months. Results Two out of the three patients who received single lamivudine developed hepatitis B virus reinfection. The reinfection occurred in one patient 6 months after orthotopic liver transplantation, and the other patient was found to be reinfected 9 months after transplantation. Five out of the 125 patients who received lamivudine and hepatitis B immunoglobulin (small dosage) developed hepatitis B virus reinfection. To 3 patients with hepatitis B virus reinfection adefovir dipivoxil was given, and hepatitis B virus-DNA negative conversion was observed after three months of treatment. Conclusions Treatment with lamivudine and low dose of hepatitis B immunoglobulin post-transplantation may offer an effective prevention against hepatitis B virus reinfection. Adefovir dipivoxil is effective for patients with reinfection of hepatitis B virus by suppressing its variant replication.
