Nucleoside plus nucleotide analogs and cessation of hepatitis B immunoglobulin after liver transplantation in chronic hepatitis B is safe and effective

Abstract

Combined prophylaxis with TDF/ETV nucleoside plus nucleotide analogs and cessation of immunoglobulin after liver transplantation in chronic hepatitis B is safe and effective.

Nucleoside–Nucleotide Analog Combination Therapy Is Effective in Preventing Recurrent Hepatitis B After Liver Transplantation

“…None of the patients developed detectable HBV DNA in the serum, and all maintained normal aminotransferase activities. Seroreversion (reappearance of HBsAg) was seen in 7.7 % of patients, which was comparable to those reported in other studies [5][6][7][8][9][10][11][12][13]. Our two patients seroreverted at 7 and 9 months post-OLT, which is also similar time period as previously reported [5][6][7][8][9][10][11][12][13].…”

“…Seroreversion (reappearance of HBsAg) was seen in 7.7 % of patients, which was comparable to those reported in other studies [5][6][7][8][9][10][11][12][13]. Our two patients seroreverted at 7 and 9 months post-OLT, which is also similar time period as previously reported [5][6][7][8][9][10][11][12][13]. In addition, like other patients who seroreverted after switching from HBIg/nucleos(t)ide to dual nucleos(t)ides, our two patients remained HBV DNA negative with normal aminotransferases [5][6][7][8][9][10][11][12][13].…”

“…The follow-up in our study was longer than the other case series. Unlike most other studies [6][7][8][9][10][11][12], we did not use a specific nucleos(t)ide combination for the cohort. Rather, a complementary nucleoside or nucleotide was added to the OLT orthotopic liver transplantation, HCC hepatocellular carcinoma Dig Dis Sci patient's preexisting antiviral regimen to provide two different drugs without potential for cross-resistance.…”

“…There is a growing experience of discontinuing HBIg and substituting a second nucleos(t)ide at various periods after OLT. There are also studies looking at other combinations for HBV prophylaxis after OLT [5][6][7][8][9][10][11][12][13][14]. Four case series reported post-OLT hepatitis B surface antigen recurrence rates between 6 and 12 % in patients treated with the combination of adefovir with lamivudine [8][9][10][11].…”

Liver transplantation in a patient with hepatitis B, C and D coinfection associated with hepatocellular carcinoma: a management strategy for a rare condition. Case report

“…3,24 However, the introduction of new nucleos(t)ide analogues, including entecavir and tenofovir, in the 2000s, modified the evolution of chronic liver disease caused by HBV. 25,26 A meta-analysis reported that among HBV-negative patients, HBV recurrence rates after OLT did not differ significantly between the group that received prophylaxis following OLT using HBIG + lamivudine and the group that received prophylaxis with entecavir or tenofovir as monotherapy (P = 0.17, risk difference: 0.06, 95% confidence interval [CI]: -0.02 to 0.14).…”