乙型肝炎病毒疫苗和乙型肝炎免疫球蛋白在核心抗体阳性肝

StephenW

De novo hepatitis b prophylaxis with hepatitis B virus vaccine and hepatitis B immunoglobulin in pediatric recipients of core antibody–positive livers
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    First published: 27 January 2016Full publication history
    DOI: 10.1002/lt.24372  View/save citation
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Abstract

The use of hepatitis B core antibody–positive (HBcAb+) grafts for liver transplantation (LT) has the potential to safely expand the donor pool, as long as proper prophylaxis against de novo hepatitis B (DNHB) is employed. The aim of this study was to characterize the longterm outcome of pediatric LT recipients of HBcAb+ liver grafts under a prophylaxis regimen against DNHB using hepatitis B virus (HBV) vaccine and hepatitis B immunoglobulin (HBIG). From June 1996 to February 2013, 49 patients receiving pediatric LT at our center were from HBcAb+ donors. Forty-one patients who received DNHB prophylaxis according to our protocol were included in this analysis. Our DNHB prophylaxis protocol consists of HBV vaccine intramuscular injections given intermittently to maintain anti–hepatitis B surface antibody (HBsAb) titers above 100 IU/L. HBIG was also used during the first posttransplant year with a target anti-HBsAb titer level above 200 IU/L. There were 19 boys and 22 girls. Median age was 1.0 year (range, 4 months to 16 years). Median follow-up time was 66 months after transplant. Median annual number of HBV vaccine injections was 0.8 per year (range, 0-1.8 per year). Four patients did not require any HBV vaccine injections during follow-up. One patient with DNHB was encountered during the follow-up period (1/41, 2.4%). DNHB was diagnosed at 3.5 years after transplant, when hepatitis B surface antigen was positive upon routine follow-up serologic testing. Anti-HBsAb titer was 101.5 IU/L at the time. No grafts were lost because of DNHB-related events. Overall survival of the 41 recipients of HBcAb+ grafts who received DNHB prophylaxis was 92.3% at 10 years after transplant. In conclusion, longterm prophylaxis against DNHB with HBV vaccine in pediatric LT recipients of HBcAb+ grafts was safe and effective in terms of DNHB incidence as well as graft and patient survival. Liver Transpl 22:247–251, 2016. © 2015 AASLD.

StephenW

乙型肝炎病毒疫苗和乙型肝炎免疫球蛋白在核心抗体阳性肝的儿科接受者中的新生乙型肝炎预防
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    首次发布：2016年1月27日全面的出版历史
    DOI：10.1002 / lt.24372查看/保存引用
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    文章的高分为53分

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抽象

只要适当预防新生乙型肝炎（DNHB），使用乙肝核心抗体阳性（HBcAb +）移植物进行肝移植（LT）就有可能安全地扩大供体池。本研究的目的是鉴定乙型肝炎病毒（HBV）疫苗和乙型肝炎免疫球蛋白（HBIG）在预防针对DNHB方案下HBcAb +肝移植的儿科LT受体的长期结局。从1996年6月至2013年2月，在我们中心接受儿科LT的49例患者来自HBcAb +供体。根据我们的方案接受DNHB预防的41例患者纳入本次分析。我们的DNHB预防方案由HBV疫苗肌内注射间歇给予，以维持100 IU / L以上的抗乙型肝炎表面抗体（HBsAb）滴度。在移植后第一年期间也使用HBIG，目标抗HBsAb滴度水平高于200IU / L。共有19名男生和22名女生。中位年龄为1.0年（范围4个月至16岁）。中位随访时间为移植后66个月。乙型肝炎疫苗注射中位数每年为0.8次（每年0-1.8次）。 4名患者在随访期间不需要注射任何HBV疫苗。在随访期间遇到一名DNHB患者（1/41，2.4％）。 DNHB在移植后3.5年被诊断出，当常规随访血清学检测时乙型肝炎表面抗原阳性。当时抗HBsAb滴度为101.5IU / L。由于DNHB相关事件，没有移植物丢失。接受DNHB预防的HBcAb +移植物的41名接受者的总生存率在移植后10年为92.3％。总之，在HBcAb +移植物的小儿LT受体中用HBV疫苗长期预防DNHB在DNHB发生率以及移植物和患者生存方面是安全有效的。肝脏Transpl 22：247-251，2016.©2015 AASLD。

smilingcloud

感谢分享。



HBIG打的真够揪心的。