New nucleos(t)ide analogue monoprophylaxis after cessation of hepatitis B immunoglobulin is effective against hepatitis B recurrence.

New nucleos(t)ide agents (NAs) [entecavir (ETV) and tenofovir (TDF)] have made hepatitis B immunoglobulin (HBIG)-sparing protocols an attractive approach against hepatitis B virus (HBV) recurrence after liver transplantation (LT). Twenty-eight patients transplanted for HBV cirrhosis in our centre were prospectively evaluated. After LT, each patient received HBIG (1000 IU IM/day for 7 days and then monthly for 6 months) plus ETV or TDF and then continued with ETV or TDF monoprophylaxis. All patients had undetectable HBV DNA at the time of LT, and they were followed up with laboratory tests including glomerular filtration rate (GFR) after LT. All patients (11 under ETV and 17 under TDF) remained HBsAg/HBV DNA negative during the follow-up period [median: 21 (range 9-43) months]. GFR was not different between TDF and ETV groups of patients at 6 and 12 months and last follow-up (P value >0.05 for all comparisons). The two groups of patients were similar regarding their ratio of maximum rate of tubular phosphate reabsorption to the GFR (TmP/GFR). In conclusion, in this prospective study, we showed for the first time that maintenance therapy with ETV or TDF monoprophylaxis after 6 months of low-dose HBIG plus ETV or TDF after LT is highly effective and safe.
AuthorsEvangelos Cholongitas, Ioannis Goulis, Nikolaos Antoniadis, Ioannis Fouzas, George Imvrios, Vasilios Papanikolaou, Evangelos Akriviadis
JournalTransplant international : official journal of the European Society for Organ Transplantation (Transpl Int) Vol. 27 Issue 10 Pg. 1022-8 (Oct 2014) ISSN: 1432-2277 [Electronic] England
PMID24909714 (Publication Type: Comparative Study, Journal Article)
Copyright© 2014 Steunstichting ESOT.
Chemical References
  • Immunoglobulins
  • Immunosuppressive Agents
  • Organophosphonates
  • hepatitis B hyperimmune globulin
  • entecavir
  • Guanine
  • Tenofovir
  • Adenine
  • Adenine (administration & dosage, analogs & derivatives)
  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Graft Rejection (prevention & control)
  • Graft Survival
  • Guanine (administration & dosage, analogs & derivatives)
  • Hepatitis B, Chronic (diagnosis, drug therapy)
  • Humans
  • Immunoglobulins (administration & dosage)
  • Immunosuppressive Agents (administration & dosage)
  • Liver Cirrhosis (pathology, surgery, virology)
  • Liver Transplantation (adverse effects, methods)
  • Male
  • Organophosphonates (administration & dosage)
  • Prospective Studies
  • Recurrence
  • Retreatment (methods)
  • Risk Assessment
  • Statistics, Nonparametric
  • Tenofovir
  • Transplantation Immunology (drug effects, physiology)
  • Treatment Outcome

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