Background: Recent data suggest that oral third-generation nucleos(t)ide analogs (NA) monoprophylaxis following hepatitis B immunoglobulin (HBIg) withdrawal may be effective to prevent HBV reinfection after liver transplantation (LT). Patients and methods: Between 01/2010 and 03/2012, all HBV monoinfected and HBV/HDV co-infected LT patients followed in our centre withdrew HBIg ± NA and were commenced on either ETV or TDF as monotherapy. Results: Seventy-seven patients were included in the study (55% TDF, 45% ETV). Group A comprised 69 HBV monoinfected patients and Group B 8 HBV/HDV co-infected patients. After HBIg withdrawal, Groups A and B patients were followed for 69 (range 13–83) months and 61 (range 31–78) months, respectively. No Group B patients had HBsAg or HBV DNA recurrence, while 6 (9%) Group A patients became HBsAg-positive after a median of 18 (range 1–40) months. The cumulative 5-year incidence of HBsAg recurrence was 9%. All 6 patients demonstrated undetectable HBV-DNA levels and stable graft function during 30 months of additional follow-up. In 3/6 patients, seroconversion was transitory, while the remaining 3 showed HBsAg levels <0.13 IU/mL over the entire period of observation. Pre-LT HCC emerged as the strongest predictor of HBsAg recurrence. Conclusion: HBIG can be safely discontinued in HBsAgpositive LT recipients and replaced by ETV or TDF monotherapy.
Entecavir or tenofovir monotherapy prevents HBV recurrence in liver transplant recipients : a 5-year follow-up study after hepatitis B immunoglobulin withdrawal / M.A. Manini, G. Whitehouse, M. Bruce, M. Passerini, T.Y. Lim, I. Carey, A. Considine, P. Lampertico, A. Suddle, N. Heaton, M. Heneghan, K. Agarwal. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 50:9(2018 Sep), pp. 944-953.
|Titolo:||Entecavir or tenofovir monotherapy prevents HBV recurrence in liver transplant recipients : a 5-year follow-up study after hepatitis B immunoglobulin withdrawal|
|Parole Chiave:||Antiviral drug-resistance mutation; HBsAg titre; HBV DNA level; Hepatocellular carcinoma; Safety; Hepatology; Gastroenterology|
|Settore Scientifico Disciplinare:||Settore MED/12 - Gastroenterologia|
|Data di pubblicazione:||set-2018|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.dld.2018.03.032|
|Appare nelle tipologie:||01 - Articolo su periodico|