Oral Nucleoside/Nucleotide Analogs Without Hepatitis B Immune Globulin After Liver Transplantation for Hepatitis B

Abstract

Oral nucleoside/nucleotide analogs without HBIG are effective in preventing graft loss secondary to hepatitis B recurrence after liver transplantation. However, new agents with a high barrier to resistance should be used to minimize drug resistance and to prevent virological rebound.

High Genetic Barrier Nucleos(t)ide Analogue(s) for Prophylaxis From Hepatitis B Virus Recurrence After Liver Transplantation: A Systematic Review

“…Of two studies (14,15) from one center in China with overlapping study periods, only the latest one (14) was included in the analysis. Moreover, there were two other studies (20,24) from another center in China with overlapping study periods, but we decided to include the oldest one (20), which was published as full paper, because it provided more details on antiviral prophylaxis. Finally, one study, which was published only as an abstract, was excluded because it did not provide separate data on HBV recurrence under hgbNA(s) (26).…”

“…In total, 94 articles were initially identified from the literature search, but only 20 studies (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) fulfilled the inclusion criteria ( Figure A1). Of two studies (14,15) from one center in China with overlapping study periods, only the latest one (14) was included in the analysis.…”

Controversies Regarding the Hepatitis B Immune Globulin Prophylaxis (HBIG) for Liver Transplantation Recipients

“…The rate of recurrence after LT was 0%. Similarly, entecavir, Telbivudine monotherapy [78,[88][89][90][91] pre-and post LT resulted in 0% to 8% HBV recurrence rate (Table 2). Only one study found a relatively high rate of recurrent HBV infection (22.5%) using ENT [91] (Table 3).…”

The role of oral antiviral therapy in hepatitis B-related hepatocellular carcinoma

“…Since then, studies have also demonstrated the efficacy of using lower doses, and also replacing HBIG with combination oral antiviral therapy [70,71] . With the introduction of more potent NAs with minimal drug resistance, oral antiviral therapy alone without HBIG has also been shown to be highly effective in preventing graft hepatitis together with excellent long-term outcome [72][73][74][75] .…”