Abstract
Background/aim In this study, the efficiency of using low-dose hepatitis B immunoglobulin (HBIG) plus antiviral treatment according to individual needs has been evaluated in posttransplant hepatitis B virus (HBV) patients.Materials and methodsWe retrospectively evaluated 179 patients who were admitted between 2009 and 2014. Five thousand IU intravenous HBIG was given in the anhepatic phase, and 400 IU/day intramuscular (IM) HBIG was given in the posttransplant period. After HBsAg seroconversion, 400 IU IM HBIG was continued as prophylaxis every two weeks.Results The average follow-up period was 26 (2–65) months. Seventy patients had hepatocellular carcinoma (HCC). The HBV recurrence was 4.5% in the first year, and 5.8% in the third year. The HBsAg became negative in 11 (2–63) days, and anti-HBs became positive in 9 (1–31) days. HBsAg positivity occurred in 6 patients during the follow-up period. Five of these patients were those who underwent transplantation due to HCC. In 5 of the HCC patients, in whom HBsAg became positive, tumor recurrence was observed after 0.3–9.9 months. HBsAg positivity was more frequently detected in patients with HCC (P = 0.009).ConclusionThe HBV recurrence should be evaluated as a predictor of the HCC recurrence in patients who were transplanted due to HCC.
Highlights
In 5 of the hepatocellular carcinoma (HCC) patients, in whom HBsAg became positive, tumor recurrence was observed after 0.3–9.9 months
The hepatitis B virus (HBV) recurrence should be evaluated as a predictor of the HCC recurrence in patients who were transplanted due to HCC
Prophylactic hepatitis B immunoglobulin (HBIG) in combination with oral antiviral therapy has become a standard treatment for patients who undergo liver transplantation surgery due to Hepatitis B [1,2,3]
Summary
Prophylactic hepatitis B immunoglobulin (HBIG) in combination with oral antiviral therapy has become a standard treatment for patients who undergo liver transplantation surgery due to Hepatitis B [1,2,3]. HBIG reduces the number of virions within the circulation and ensures the lysis of infected hepatocytes. Escape and surface mutants may sometimes develop in the course of treatment. On the other hand, inhibit the reinfection of hepatocytes as well as the replication of the mutant virions that have developed. 2) For the initial 3–7 days after the liver transplantation, 2000 to 10,000 IU HBIG a day is administered in an intramuscular or intravenous way. There are HBIG regimens used in different ways [5,6,7,8,9] as follows; 1) In anhepatic phase, HBIG is administered intravenously (IV) as 4000–10,000 IU/mL [10]. 2) For the initial 3–7 days after the liver transplantation, 2000 to 10,000 IU HBIG a day is administered in an intramuscular or intravenous way. 3) In order to ensure the maintenance of anti-HBs
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