Hepatitis B virus recurrence after liver transplantation: Prevention and cure efficacy of nucleoside anti-hepatitis B medicine combined with low-dose anti-hepatitis B immunoglobulin / 中国组织工程研究

ABSTRACT

BACKGROUND: It was reported from home and abroad that the effect of nucleoside anti-hepatitis B medicine and anti-hepatitis B immunoglobulin for prevention and cure of hepatitis B virus recurrence after liver transplantation with hepatopathy correlation with hepatitis B was good for patients. But the reported dosage of anti-hepatitis B immunoglobulin in and after liver transplantation was different. OBJECTIVE: To verify and investigate the effect of nucleoside anti-hepatitis B medicine combined with anti-hepatitis B immunoglobulin on prevention and cure of hepatitis B virus recurrence after liver transplantation, METHODS: A retrospective analysis was performed on 59 patients with liver transplantation of hepatopathy correlated with hepatitis B who were selected from Liver Transplantation Center, the Ganmay Affiliated Hospital of Kunming Medical College between May 2006 and February 2009. A total of 50 out of 59 cases were diagnosed with posthepatitic cirrhosis in decompensatio stage before transplantation, including 15 cases having positive hepatitis B DNA. Before liver transplantation, 5 cases accepted Lamivudine, 1 case accepted Adefovir dipivoxil, and 1 case accepted Entecavir. Treatment time ranged from two weeks to one year. All the patients accepted intramascular injection of anti-hepatitis B irnrnunoglobulin, 200 U/d; which were adjusted in the light of hepatitis B surface antibody titer. A total of 55 out of 59 cases accepted Lamivudine, 3 cases accepted Adefovir dipivoxil, and 1 case accepted Eetecavir after liver transplantation. RESULTS AND CONCLUSION: Two patients underwent hepatitis b virus reinfection, but HBV variants (YMDD) reinfection was not determined, one of which occurred in one year after liver transplantation with positive pre-OLT serum hepatitis b virus DNA, another after one year with negative pre-OLT serum hepatitis b virus DNA. The reinfection rate of group with negative or positive pre-OLT serum HBV DNA was 2% and 7%, respectively, it was maybe well prevention and cure of hepatitis B after liver transplantation that patients accepted nucleoside anti-hepatitis B medicine combined with low close anti-hepatitis B immunoglobulin (200 U/d).