Long-term outcome of patients with lamivudine after early cessation

liver411

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Clinical Transplantation
Early View (Articles online in advance of print)
Published Online: 15 Jun 2010
© 2010 John Wiley & Sons A/S


Long-term outcome of patients with lamivudine after early cessation of
hepatitis B immunoglobulin for prevention of recurrent hepatitis B following
liver transplantation

M. Yuefeng, F. Weili, T. Wenxiang, X. Ligang, L. Guiling, G. Hongwei, L.
Wencai, W. Xiaoguang, M. Wei and F. Zhongyi

Department of Hepatobiliary Surgery, Dalian Institute of Hepatobiliary
Surgery, Dalian Friendship Hospital, Dalian, China

Corresponding author:F.U. Weili, Department of Hepatobiliary Surgery, Dalian
Institute of Hepatobiliary Surgery, Dalian Friendship Hospital, Dalian, China.
Tel.: 0411-82718822-3308; fax: 0411-82718822-3308; e-mail:
[email protected]

Conflict of interest: None.

Copyright © 2010 John Wiley & Sons A/S

ABSTRACT
Yuefeng M, Weili F, Wengxiang T, Ligang X, Guiling L, Hongwei G, Wencai L,
Xiaoguang W, Wei M, Zhongyi F. Long-term outcome of patients with lamivudine
after early cessation of hepatitis B immunoglobulin for prevention of
recurrent hepatitis B following liver transplantation.
Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01290.x. © 2010 John Wiley
& Sons A/S.

Abstract:

Background: The aim of this study is to examine the efficacy of long-term
prophylaxis with lamivudine (LAM) after a course of post-operative hepatitis B
immunoglobulin (HBIG) in patients who underwent liver transplantation (LT) for
hepatitis B virus (HBV)-related disease.

Result: The medical records of HBV-infected patients who underwent a LT in our
institution between July 2001 and May 2005 were reviewed. There were 15 liver
transplant recipients who were administered HBIG for <18 months and used LAM
as a maintenance prophylaxis regime enrolled in this study. At enrollment, all
patients were hepatitis B surface antigen (HBsAg) positive and three patients
were HBeAg positive. There were 13 patients who were HBV DNA positive with a
mean viral load of 5.4 log copies/mL, and among them, 12 recipients were on
antiviral therapy with LAM (100 mg/d orally) for 12–168 d, resulting in HBV
DNA negative levels in nine patients prior to their transplant. HBV recurrence
post-LT was noted in two patients who had very high-HBV DNA levels pre-LT.
Both of these patients showed LAM-resistant mutation at the time of
recurrence. The 11 patients who were HBV DNA negative before LT (low-risk
patients) had no HBV recurrence during a follow-up at a median of 58 months
post-LT. This included five patients who had intermittent low-level HBV DNA
post-LT (HBsAg negative), of whom two had YMDD mutation and these two were
given adefovir in addition to LAM.

Conclusion: Our retrospective study demonstrated excellent long-term outcomes
in the low-risk patients treated with LAM after a short course of HBIG.

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Accepted for publication 27 April 2010
DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1399-0012.2010.01290



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