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The role of HBIg as hepatitis B reinfection prophylaxis following liver transplantation

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Abstract

Background and introduction

Without adequate prophylaxis, liver transplantation (LTx) is frequently followed by hepatitis B virus (HBV) reinfection, which results in rapidly progressing liver disease and significantly decreased overall survival. In the last two decades, significant progress has been made in the prophylaxis and treatment of HBV.

Discussion

We present an overview of different protocols and regimens used for prophylaxis of HBV reinfection after LTx and describe the protocol implemented at our center. Following LTx, HBV reinfection can be effectively prevented by administration of anti-hepatitis B immunoglobulin (HBIg) alone or more recently in combination with antiviral nucleoside/nucleotide analogs (NUCs). Several studies reported good results with the use of HBIg alone, but combination treatment with HBIg and NUCs has proven to be a superior prophylactic regimen for HBV recurrence. At present, combination therapy (HBIg and a nucleoside or nucleotide analog) is the gold standard used in many transplantation centers. This preventive regimen reduces the risk of a recurrence of HBV infection and thereby the need for re-transplantation. Future and ongoing studies will show how long HBIg must be given after transplantation, especially when used in combination with potent antivirals, such as entecavir or tenofovir.

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Conflicts of interest

This literature analysis was supported by “Transplantationszentrum Heidelberg” and “Biotest AG, Germany”.

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Authors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Arianeb Mehrabi, Majid Esmaeilzadeh, Hamidreza Fonouni, Mohammadreza Hafezi, Nuh N. Rahbari, Mohammad Golriz, Ali Majlesara, Morva Tahmasbi Rad & Jan Schmidt

  2. Department of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany

    Mahmoud Sadeghi

  3. Department of Gastroenterology, Hepatology and Infectious Diseases, University of Heidelberg, Heidelberg, Germany

    Tom M. Ganten

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  1. Arianeb Mehrabi
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  2. Majid Esmaeilzadeh
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Correspondence to Arianeb Mehrabi.

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Mehrabi, A., Esmaeilzadeh, M., Fonouni, H. et al. The role of HBIg as hepatitis B reinfection prophylaxis following liver transplantation. Langenbecks Arch Surg 397, 697–710 (2012). https://doi.org/10.1007/s00423-011-0795-6

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  • DOI: https://doi.org/10.1007/s00423-011-0795-6

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