Recurrence of Hepatitis B Infection in Liver Transplant Patients Receiving Long-Term Hepatitis B Immunoglobulin Prophylaxis

被引：12

作者：

Beckebaum, Susanne ^{[1
]}

Herzer, Kerstin ^{[2
]}

Bauhofer, Artur ^{[3
,4
]}

Gelson, William ^{[5
]}

De Simone, Paolo ^{[6
]}

de Man, Robert ^{[7
]}

Engelmann, Cornelius ^{[8
]}

Muellhaupt, Beat ^{[9
]}

Vionnet, Julien ^{[10
,11
]}

Salizzoni, Mauro ^{[12
]}

Volpes, Riccardo ^{[13
]}

Ercolani, Giorgio ^{[14
]}

De Carlis, Luciano ^{[15
]}

Angeli, Paolo ^{[16
]}

Burra, Patrizia ^{[16
]}

Dufour, Jean-Francois ^{[17
]}

Rossi, Massimo ^{[18
]}

Cillo, Umberto ^{[19
]}

Neumann, Ulf ^{[20
]}

Fischer, Lutz ^{[21
]}

Niemann, Gabriele ^{[3
,4
]}

Toti, Luca ^{[22
]}

Tisone, Giuseppe ^{[22
]}

机构：

[1] Univ Hosp Munster, Dept Gastroenterol & Hepatol, Munster, Germany

[2] Univ Hosp Essen, Dept Gastroenterol & Hepatol, Essen, Germany

[3] Biotest AG, Corp Med Affairs, Dreieich, Germany

[4] Biotest AG, Corp Clin Res & Dev, Dreieich, Germany

[5] Addenbrookes Hosp, Cambridge Liver Unit, Cambridge, England

[6] Chirurg Epat & Trapianto Fegato Pisa, Hepatobiliary Surg & Liver Transplantat, Pisa, Italy

[7] Erasmus MC, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[8] Univ Leipzig, Dept Gastroenterol & Rheumatol, Leipzig, Germany

[9] Univ Hosp Zurich, Swiss HPB Ctr & Gastroenterol & Hepatol, Zurich, Switzerland

[10] Transplantat Ctr, Lausanne, Switzerland

[11] Serv Gastroenterol & Hepatol, Lausanne, Switzerland

[12] AO Citta Salute & Sci Torino, Chirurg Gen 2U, Ctr Trapianto Fegato, Turin, Italy

[13] ISMETT IRCCS, Hepatol & Gastroenterol Unit, Palermo, Italy

[14] Univ Bologna, Dept Gen Surg, Morgagni Pierantoni Gen Hosp, Bologna, Italy

[15] Osped Niguarda Ca Granda, Surg & Abdominal Transplantat Div, Milan, Italy

[16] Padua Univ Hosp, Multivisceral Transplant Unit, Padua, Italy

[17] Univ Clin Visceral Surg & Med, Inselspital, Bern, Switzerland

[18] Sapienza Univ, Umberto Policlin 1, Dept Gen Surg & Organ Transplantat, Rome, Italy

[19] Univ Hosp Padua, Multivisceral Transplant Unit, Dept Surg Oncol & Gastroenterol, Gastroenterol, Padua, Italy

[20] Univ Hosp RWTH Aachen, Dept Visceral & Transplantat Surg, Aachen, Germany

[21] Univ Med Ctr Hamburg Eppendorf, Dept Hepatobiliary & Transplant Surg, Hamburg, Germany

[22] Azienda Osped Policlin Tor Vergata, Transplant Ctr, Fac Med, Rome, Italy

来源：

ANNALS OF TRANSPLANTATION | 2018年 / 23卷

关键词：

Hepatitis B virus; Liver Transplantation; Recurrence; ANTIGEN-POSITIVE PATIENTS; HEPATOCELLULAR-CARCINOMA; VIRUS INFECTION; ACUTE REJECTION; RECIPIENTS; SURVIVAL; OUTCOMES; RATES; PROLIFERATION; MANAGEMENT;

D O I：

10.12659/AOT.910176

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Long-term real-world data are relatively sparse regarding recurrence of chronic hepatitis B virus (HBV) infection after liver transplantation using hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogue (NUC) prophylaxis. MAterial/Methods: Data from 371 adults transplanted for HBV-related disease at 20 European centers and given HBIg for >= 12 months +/- NUC therapy were analyzed retrospectively. Results: HBIg comprised Hepatect (R) (iv HBIgB; n=299), subcutaneous Zutectra (R) (sc HBIg, n=236), and other HBIg preparations (n=130); 93.5% received NUC therapy. Mean follow-up was 6.8 +/- 3.5 years. The primary efficacy variable, freedom from HBV recurrence, occurred in 95.7% of patients (95% CI [93.1%, 97.5%]). The observed incidence of recurrence was 16/371 (4.3%) (annual rate 0.65%); 5/16 patients with recurrence had discontinued HBIg and 7/16 had anti-HBs < 100 IU/I. Excluding these 7 patients, the HBV recurrence rate was 2.4%. The recurrence rate while on HBIg therapy was 1 per 2069 months. In patients who discontinued HBIg, risk of HBV recurrence versus sc HBIg users was increased by 5.2-fold (1 per 1 603 versus 1 per 8379 treatment months). The annual rate of HBV-related hepatocellular carcinoma (HCC) recurrence was 1.7%. Conclusions: These results support the long-term use of HBIg with NUC therapy as an effective management strategy to minimize risk of HBV recurrence and virus-related complications after liver transplantation.

引用

页码：789 / 801

页数：13

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