Antiviral treatment for hepatitis B virus recurrence following liver transplantation

作者：Lee Sanghoon; Kwon Choon Hyuck D^*; Moon Hyung Hwan; Kim Tae Seok; Roh Youngnam; Song Sanghyun; Shin Milljae; Kim Jong Man; Park Jae Berm; Kim Sung Joo; Joh Jae Won; Lee Suk Koo

来源：Clinical Transplantation, 2013, 27(5): E597-E604.

DOI：10.1111/ctr.12212

• antiviral therapy
• HBV recurrence
• hepatitis B virus
• liver transplantation

The purpose of this study was to identify the factors associated with the recurrence of hepatitis B virus (HBV) following liver transplantation (LT) for HBV-related disease and to recognize the outcome of treatment for HBV recurrence with oral nucleos(t)ide analogues. Six hundred and sixty-seven LTs were performed for HBsAg-positive adult patients in our institute from 1996 to 2010. HBV prophylaxis was performed by hepatitis B immunoglobulin (HBIG) monotherapy or HBIG and entecavir combination therapy. There were 63 cases (11.4%) of HBV recurrences during a median follow-up of 51months. The median time to HBV recurrence was 22months. A preoperative HBV DNA load of more than 10(5)IU/mL, HBIG monotherapy, and hepatocellular carcinoma in the explant liver were independent risk factors for HBV recurrence following LT in multivariate analysis. Patient survival at 10yr was 54.2% for HBV-recurrent patients. Among patients with HBV recurrence, HBsAg seroclearance was achieved in 13 patients (20.6%), but HBsAg seroclearance did not affect survival in these patients after the recurrence of HBV (p=0.28). The recurrence of HBV led to graft failure in six cases. HBV recurrence should be prevented by strict management of pre-transplant HBV viremia and an effective post-transplant HBV prophylaxis.

• 出版日期2013-9