Hepatitis B immunoglobulins and/or lamivudine for preventing hepatitis B recurrence after liver transplantation: A systematic review

Abstract

Long-term HBIg prophylaxis or lamivudine prophylaxis can reduce the risk for hepatitis B virus recurrence. Long-term high-dose HBIg combined with lamivudine can further reduce HBV recurrence to less than 10%.

Intravenous immunoglobulins in liver transplant patients: Perspectives of clinical immune modulation

“…Since the immunologic benefit was not paid with an increased risk of infections, these data obviously indicated beneficial immuno-balancing capabilities of HBIg [67] . In contrast, the risk of bacterial infections was significantly higher in 21 patients with alcoholic liver cirrhosis (P < 0.05), although their immunologic outcome was comparable to that of HBV-positive liver recipients (Table 1).…”

“…Besides producing significant costs, longterm HBIg monotherapy may promote the development of viral mutations [62,63] . Therefore, a combination of HBIg with potent nucleos(t)ide analogues (NA) is considered as gold standard in prophylaxis of recurrent HBV [62][63][64][65][66][67] . Currently, the combination of anti-HBs Ig with tenofovir or entecavir is under clinical evaluation [62,68] .…”

Hepatitis B and Liver Transplantation: Update in Management before and after Transplantation

“…The superiority of combination HBIG and antiviral prophylaxis was demonstrated in two recent meta-analyses where the rate of recurrent HBV infection was found to be less than 10% in patients that received combination therapy, compared to 4% to 65% in patients given HBIG alone and 4% to 40% in patients given LAM alone [26,27]. These findings were also confirmed in a large, singlecenter retrospective cohort of 1524 patients by Hwang et al [28•] where none of the patients who were given combination prophylaxis developed recurrent HBV, compared to 9.8% of patients given HBIG over 10 years.…”

Viral Hepatitis in Solid Organ Transplant Recipients

“…In the mid 1990s, Lamivudine (LAM), the first oral antiviral agent for HBV, in addition to hepatitis B immunoglobulin (HBIG) revolutionized the treatment of HBV. Long-term high-dose HBIG combined with LAM can reduce HBV recurrence to less than 10% (Chen, Yi et al 2010). However, combined treatment with HBIG and LAM is sometimes unable to control recurrent HBV infection.…”