Liver transplantation
Comparison between levels of anti-HBS with a fixed administration dose of HBIG and a combination of HBIG and lamivudine for the prophylaxis of hepatitis B after liver transplantation

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Materials and methods

From April 1990 to December 2000, 27 HbsAg + patients underwent liver transplantation at Virgen del Rocío University Hospital in Seville; 21 men and six women. The mean age was 46.33 ± 11.61 years. All patients received i.v. HBIg (Hepatect, Biotest Pharma GmbH, Germany): 10,000 U during the anhepatic phase, 10,000 U from the first to the sixth day, 10,000 U monthly during the first year, and 10,000 U each 2 months during the second and the third years; from then on, the administration interval

Results

Figure 1 shows the risk of HBV recurrence in both groups according to the Kaplan–Meier curve. Four of the 17 patients in Group I, with a median follow-up of 71 months, became reinfected with HBV. The reinfections all appeared during the first year, despite the increased interval in HBIg administration during the first 12 months. Among Group II patients, with a median follow-up of 30.1 months, no patient became reinfected. Fisher’s exact probability test showed no statistically significant

Discussion and conclusions

Reinfection with HBV occurred almost exclusively during the first year in those patients who received prophylaxis with fixed doses of HBIg with and without lamivudine, despite the fact that the dose was reduced from the second year. This finding probably relates to the increased half-life of HBIg as the time posttransplant increases.2 The lower degree of long-term immunosuppression at these times reduces the probability of viral reactivation. The protective level of anti-HBs required to avoid

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Cited by (18)

  • Hepatitis B Immunoglobulin and Lamivudine Improve Hepatitis B-Related Outcomes After Liver Transplantation: Meta-Analysis

    2008, Clinical Gastroenterology and Hepatology
    Citation Excerpt :

    Initially, 7 studies were identified from the total of 272 screened, but one was excluded because the outcome data could not be extracted for the 2 treatment groups (Figure 1).16 Of the 6 eligible studies17–22 included in the meta-analysis for HBV recurrence, 2 were prospective,18,21 and 4 were retrospective17,19,20,22 (Table 1). All studies were published in English and were conducted in the following countries: 1 each in Australia,21 Spain,22 and France,18 and 3 in the United States.17,19,20

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