Entecavir Combined With Short-term Hepatitis B Immunoglobulin in Preventing Hepatitis B Virus Recurrence in Liver Transplant Recipients

Transplant Proc. 2023 Mar;55(2):408-412. doi: 10.1016/j.transproceed.2023.02.006. Epub 2023 Mar 10.

Abstract

Background: The combination of nucleoside analogs and long-term hepatitis B immunoglobulin (HBIG) is considered to be the standard regimen for preventing hepatitis B virus (HBV) recurrence after liver transplant (LT). However, long-term use of HBIG causes many adverse effects. The aim of this study was to evaluate the effect of nucleoside analogs entecavir combined with short-term HBIG in preventing HBV recurrence after LT.

Methods: This retrospective study assessed the effect a combination of entecavir and short-term HBIG in prophylaxis of HBV recurrence among 56 LT recipients who had undergone the procedure because of HBV-associated liver disease at our center between December 2017 and December 2021. All patients received entecavir treatment combined with HBIG for the prevention of hepatitis B recurrence, and HBIG treatment was withdrawn within 1 month. The patients were followed up to determine levels of hepatitis B surface antigen, antibody to hepatitis B surface antigen (HBsAb), and HBV-DNA and the recurrence rate of HBV.

Results: Only 1 patient appeared positive for hepatitis B surface antigen at 2 months post-LT. The overall HBV recurrence rate was 1.8%. The HBsAb titers of all patients gradually decreased over time, with a median of 376.6 IU/L at 1 month post-LT and a median of 13.47 IU/L at 12 months post-LT. During the follow-up period, the HBsAb titer of the preoperative HBV-DNA-positive patients remained at a lower level than that of HBV-DNA-negative patients.

Conclusions: Entecavir combined with short-term HBIG can exert a good effect for the prevention of HBV reinfection post-LT.

MeSH terms

  • Antiviral Agents / adverse effects
  • DNA, Viral
  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B virus / genetics
  • Hepatitis B* / diagnosis
  • Hepatitis B* / etiology
  • Hepatitis B* / prevention & control
  • Humans
  • Immunoglobulins / therapeutic use
  • Liver Transplantation* / adverse effects
  • Nucleosides
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome

Substances

  • hepatitis B hyperimmune globulin
  • Hepatitis B Surface Antigens
  • Antiviral Agents
  • DNA, Viral
  • entecavir
  • Nucleosides
  • Immunoglobulins
  • Hepatitis B Antibodies