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Efficacy of Newer Nucleos(t)ide Analogs After Hepatitis B Immunoglobulin Discontinuation Against Hepatitis B and D Recurrence in Liver Transplant Recipients
Resource type
Journal Article
Authors/contributors
- Cholongitas, Evangelos (Author)
- Oikonomou, Theodora (Author)
- Bafa, Konstantina (Author)
- Sinakos, Emmanouil (Author)
- Papatheodoridis, George V. (Author)
- Goulis, Ioannis (Author)
Title
Efficacy of Newer Nucleos(t)ide Analogs After Hepatitis B Immunoglobulin Discontinuation Against Hepatitis B and D Recurrence in Liver Transplant Recipients
Abstract
Background.
The use of nucleos(t)ide analogs (NAs) with a high genetic barrier to resistance, namely entecavir and tenofovir, has improved the efficacy of antiviral prophylaxis against hepatitis B virus (HBV) recurrence after liver transplantation (LT). However, the optimal duration and dosage of hepatitis B immunoglobulin (HBIG) administration, particularly in patients transplanted for HBV and hepatitis D virus (HDV) coinfection, remains controversial.
Methods.
We evaluated 28 patients transplanted for HBV/HDV cirrhosis. After LT, each patient received a fixed scheme of low-dose HBIG plus NA for 6 mo post-LT and then continued with long-term NA prophylaxis (entecavir: 8, tenofovir: 20 patients).
Results.
During 72 mo of follow-up, reappearance of hepatitis B surface antigen at low titers was observed in 1 (3.6%) patient at 33 mo after HBIG discontinuation, which became negative after a single dose of HBIG 1000 IU/L, whereas both serum HBV DNA and HDV RNA remained persistently undetectable and without any clinical or biochemical evidence of HBV/HDV recurrence.
Conclusions.
We showed for the first time the efficacy of a short, fixed scheme of low-dose HBIG plus NA followed by long-term NA monoprophylaxis against HBV/HDV recurrence after LT, although careful follow-up is needed after HBIG discontinuation, whereas further larger studies are needed to confirm these findings.
Publication
Transplantation
Date
09/2024
Volume
108
Issue
9
Pages
e239-e244
Accessed
11/21/24, 5:10 PM
ISSN
0041-1337, 1534-6080
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Cholongitas, E., Oikonomou, T., Bafa, K., Sinakos, E., Papatheodoridis, G. V., & Goulis, I. (2024). Efficacy of Newer Nucleos(t)ide Analogs After Hepatitis B Immunoglobulin Discontinuation Against Hepatitis B and D Recurrence in Liver Transplant Recipients. Transplantation, 108(9), e239–e244. https://doi.org/10.1097/TP.0000000000005027
ORGANISMS
SOLID ORGANS AND MCSS
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