Use of combined treatment of hepatitis B immune globulin and lamivudine as prevention of hepatitis B virus recurrence in liver allograft

Arbizu, Eduardo Albéniz; Marugán, Rafael Bárcena; Nieto, Elena; Lindeman, M Mateo; González, Miguel; Lopez, E; García, Gómez

doi:10.1016/s0041-1345(03)00687-0

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…Regardless, in this study, similar percentages of patients had transient detection of serum HBV DNA whether given HBIg or not. The protection from graft reinfection by adefovir dipivoxil in this or smaller studies29–32 compares favorably with the protection of patients given HBIg,8–11, 25 lamivudine monotherapy with or without a short course of HBIg,15, 16, 33–38 or ongoing HBIg and lamivudine 17, 30, 34, 39–44. Two caveats, however, must be emphasized: (1) Our study was not designed to compare prospectively the prophylactic efficacy of adefovir dipivoxil with or without HBIg, and (2) the median follow‐up of patients after receiving an on‐study transplant was only 36 weeks, which is insufficient to conclude definitively that long‐term protection was equivalent between the 2 groups.…”

Section: Discussionmentioning

confidence: 87%

Adefovir dipivoxil for wait-listed and post–liver transplantation patients with lamivudine-resistant hepatitis B: Final long-term results

Schiff¹,

Lai²,

Hadziyannis³

et al. 2007

Liver Transpl

236

198

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Wait-listed (n ϭ 226) or post-liver transplantation (n ϭ 241) chronic hepatitis B (CHB) patients with lamivudine-resistant hepatitis B virus (HBV) were treated with adefovir dipivoxil for a median of 39 and 99 weeks, respectively. Among wait-listed patients, serum HBV DNA levels became undetectable (Ͻ1,000 copies/mL) in 59% and 65% at weeks 48 and 96, respectively. After 48 weeks, alanine aminotransferase (ALT), albumin, bilirubin, and prothrombin time normalized in 77%, 76%, 60%, and 84% of wait-listed patients, respectively. Among posttransplantation patients, serum HBV DNA levels became undetectable in 40% and 65% at weeks 48 and 96, respectively. After 48 weeks, ALT, albumin, bilirubin, and prothrombin time normalized in 51%, 81%, 76%, and 56% of posttransplantation patients, respectively. Among wait-listed patients who underwent on-study liver transplantation, protection from graft reinfection over a median of 35 weeks was similar among patients who did (n ϭ 34) or did not (n ϭ 23) receive hepatitis B immunoglobulin (HBIg). Hepatitis B surface antigen was detected on the first measurement only in 6% and 9% of patients who did or did not receive HBIg, respectively. Serum HBV DNA was detected on consecutive visits in 6% and 0% of patients who did or did not receive HBIg, respectively. Treatment-related adverse events led to discontinuation of adefovir dipivoxil in 4% of patients. Cumulative probabilities of resistance were 0%, 2%, and 2% at weeks 48, 96, and 144, respectively. In conclusion, adefovir dipivoxil is effective and safe in wait-listed or posttransplantation CHB patients with lamivudine-resistant HBV and prevents graft reinfection with or without HBIg. Liver Transpl 13:349-360, 2007.

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Section: Discussionmentioning

confidence: 87%

Adefovir dipivoxil for wait-listed and post–liver transplantation patients with lamivudine-resistant hepatitis B: Final long-term results

Schiff¹,

Lai²,

Hadziyannis³

et al. 2007

Liver Transpl

236

198

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“…However, the data for the efficacy of long‐term LAM therapy in patients with decompensated liver disease associated with viral replication, liver function and safety profile are limited to date. LAM is also effective for the treatment of recurrent hepatitis B infection after transplantation, based on improvement in virological parameters of infection as well as clinical and histological manifestations of the disease 10,11 …”

Section: Introductionmentioning

confidence: 99%

Timing of lamivudine administration according to Child class in patients with decompensated cirrhosis

Bae

Yoon

Choi

et al. 2005

J of Gastro and Hepatol

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“…Several studies have attempted to replace long‐term HBIG with active immunization after varying durations of HBIG, with conflicting results 16–19. Others have tried to lower the cost of HBIG by administering it intramuscularly (IM) at lower doses 20–25. Finally, other investigators have tried to discontinue HBIG altogether after the initial post‐OLT period and continue with antiviral monotherapy in patients at low risk for HBV recurrence (hepatitis B e antigen [HBeAg] negative with undetectable HBV DNA by non–polymerase chain reaction [PCR]‐based assays at transplant), with recurrence rates varying from 0 to 16% 26–28.…”

mentioning

confidence: 99%

Low risk of hepatitis B virus recurrence after withdrawal of long-term hepatitis B immunoglobulin in patients receiving maintenance nucleos(t)ide analogue therapy

et al. 2007

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Hepatitis B virus (HBV) recurrence rates of 0-16% had been reported in patients maintained on nucleoside analogues (NA) after hepatitis B immunoglobulin (HBIG) discontinuation after orthotopic liver transplantation (OLT). However, follow-up in most studies was short. We aimed to determine the long-term risk of HBV recurrence using this strategy. All HBV patients who received Ն7 doses of intravenous HBIG after OLT, with no HBV recurrence while receiving HBIG, and who eventually discontinued HBIG and were maintained on NA, were included. HBV recurrence was defined as HBsAg-positive or HBV DNA Ն5 log copies/mL on 2 consecutive occasions. Twenty-one patients met the inclusion criteria. Immediate post-OLT prophylaxis was combination HBIG and NA in 15 patients, whereas 6 patients received HBIG monotherapy for 62-109 months before NA was added. HBIG was discontinued a median of 26 (range, 0.2-121) months after OLT. Median follow-up post-HBIG discontinuation was 40 (range, 5-51) months. Only 1 patient, who had 12 months of HBIG and was noncompliant to NA therapy, had HBV recurrence, 34 months after HBIG discontinuation. One patient had HBV DNA of 3.3 log copies/mL 47 and 48 months after HBIG discontinuation but remained HBsAg-negative. Lamivudine-resistant mutations were detected in both patients. Probability of HBV recurrence was 0% and 9% at 2 and 4 years after HBIG discontinuation. Three patients had 1-2 episodes of transiently detectable HBV DNA. All were HBV DNA and HBsAg negative on repeated tests over a period of 2-36 months. Maintenance therapy with NA after discontinuation of long-term HBIG therapy is associated with a low risk of HBV recurrence after OLT in compliant HBV patients. Liver Transpl 13: [374][375][376][377][378][379][380][381] 2007. © 2007 AASLD.Received June 29, 2006; accepted October 18, 2006. Before the advent of antiviral prophylaxis, the prognosis of patients undergoing orthotopic liver transplantation (OLT) for hepatitis B virus (HBV)-related liver disease was poor because of the high (80-100%) rate of graft reinfection after OLT.1,2 Recurrence of hepatitis B in liver transplant recipients generally follows a more aggressive course than in immunocompetent patients, with a 2-year mortality of 50%. Fortunately, tremendous strides in antiviral prophylactic measures have been made in the last 20 years. 3 The administration of either high-dose intravenous (IV) hepatitis B immunoglobulin (HBIG) or lamivudine (LAM) for an indefinite duration after OLT have resulted in a marked reduction in 3-year HBV recurrence rates to 15-25% for HBIG [4][5][6] and 20-40% for LAM monotherapy. [7][8][9] In recent years, the combination of IV HBIG and LAM resulted in further reduction in HBV recurrence rates to less than 10% up to 3 years after OLT. 6,[10][11][12][13]

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Use of combined treatment of hepatitis B immune globulin and lamivudine as prevention of hepatitis B virus recurrence in liver allograft

Cited by 7 publications

References 9 publications

Adefovir dipivoxil for wait-listed and post–liver transplantation patients with lamivudine-resistant hepatitis B: Final long-term results

Adefovir dipivoxil for wait-listed and post–liver transplantation patients with lamivudine-resistant hepatitis B: Final long-term results

Timing of lamivudine administration according to Child class in patients with decompensated cirrhosis

Low risk of hepatitis B virus recurrence after withdrawal of long-term hepatitis B immunoglobulin in patients receiving maintenance nucleos(t)ide analogue therapy

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