Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation

S. Forrest Dodson, Michael E. De Vera, C. Andrew Bonham, David A. Geller, Jorge Rakela, John J. Fung

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

The prevention of recurrent hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT) with hepatitis B immunoglobulin (HBIG) is expensive and requires indefinite parenteral administration. Lamivudine is a nucleoside analogue capable of inhibiting HBV replication. The aim of this study is to determine the efficacy of lamivudine in the prevention of recurrent HBV infection after a course of HBIG in patients who were hepatitis B surface antigen (HBsAg) positive and hepatitis Be antigen (HBeAg) negative before OLT. Patients at high risk for recurrent HBV infection (HBeAg positive and HBV DNA positive) were excluded. Thirty HBsAg-positive, HBeAg-negative patients underwent OLT from January 1993 to June 1997. All 30 patients were administered HBIG after OLT and, after 2 years, were given the option of continuing with HBIG or switching to lamivudine. Five patients were excluded: 3 patients were lost to follow-up and 2 patients died of technical complications. Three patients terminated HBIG therapy at 8, 24, and 29 months after OLT, and reinfection with HBV occurred in 1 patient. Six patients elected to continue HBIG therapy for life; 1 patient died of melanoma and the remaining 5 patients are HBsAg negative, with an average follow-up of 73 months. Sixteen patients were converted to lamivudine after a course of HBIG, and all 16 patients are HBsAg negative, with an average follow-up of 51 months after OLT. Five patients have been on lamivudine monotherapy for more than 24 months. These results suggest that lamivudine administered after a posttransplantation course of HBIG can effectively prevent the recurrence of HBV infection in patients who are HBsAg positive and HBeAg negative before OLT.

Original languageEnglish (US)
Pages (from-to)434-439
Number of pages6
JournalLiver Transplantation
Volume6
Issue number4
StatePublished - 2000

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Lamivudine
Hepatitis B
Liver Transplantation
Immunoglobulins
Recurrence
Hepatitis B virus
Hepatitis B Surface Antigens
Hepatitis B e Antigens
Virus Diseases
Passive Immunization
Lost to Follow-Up
Virus Replication
Nucleosides

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation. / Dodson, S. Forrest; De Vera, Michael E.; Bonham, C. Andrew; Geller, David A.; Rakela, Jorge; Fung, John J.

In: Liver Transplantation, Vol. 6, No. 4, 2000, p. 434-439.

Research output: Contribution to journalArticle

Dodson, S. Forrest ; De Vera, Michael E. ; Bonham, C. Andrew ; Geller, David A. ; Rakela, Jorge ; Fung, John J. / Lamivudine after hepatitis B immune globulin is effective in preventing hepatitis B recurrence after liver transplantation. In: Liver Transplantation. 2000 ; Vol. 6, No. 4. pp. 434-439.
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