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A clinical‐pathological analysis of hepatitis B virus recurrence after liver transplantation in C hinese patients
Author(s) -
Gao Yinjie,
Zhang Min,
Jin Bo,
Meng Fanping,
Ma Xuemei,
Liu Zhenwen,
Su Haibin,
Zhao Jingmin,
Li Hanwei
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12404
Subject(s) - medicine , entecavir , lamivudine , hepatocellular carcinoma , gastroenterology , hepatitis b virus , liver transplantation , hepatitis b , nucleoside analogue , univariate analysis , liver disease , transplantation , immunology , virus , multivariate analysis , nucleoside , stereochemistry , chemistry
Background and Aim Liver transplantation ( LT ) for hepatitis B virus ( HBV )‐related disease can be complicated by HBV recurrence. The aim of this study was to evaluate the risk factors, prophylaxis treatment, and histological characteristics of HBV recurrence after LT when using long‐term, low‐dose hepatitis B immunoglobulin ( HBIG ) plus nucleoside analog (lamivudine [ LAM ] or entecavir [ ETV ]). Methods Retrospective data from 253 adult LT patients using long‐term, low‐dose HBIG plus nucleoside analog after LT , for a mean treatment duration of 1–72 months, were collected from a single center in B eijing, C hina. Univariate analyses were conducted to determine the association among gender, age, hepatocellular carcinoma, hepatitis B e antigen‐positive status, HBV ‐ DNA level and tyrosine‐methionine‐aspartate‐aspartate (YMDD) mutations on HBV recurrence in these patients. Results Overall, the HBV recurrence rate was 6.32% (16/253). There was no significant difference in the survival rate between the HBV recurrence and non‐recurrence groups. Risk factors for HBV recurrence were: hepatitis B e antigen positivity, HBV ‐ DNA > 10 5 copies/ mL , hepatocellular carcinoma, and YMDD mutation. Sixteen patients receiving LAM had HBV recurrence (16/169; mean treatment duration: 61.8 ± 18.3 months). No HBV recurrence occurred in patients receiving ETV after LT (0/84; mean treatment duration: 57.1 ± 15.9 months). Differences in rate of mortality and HBV recurrence were not significant between the two groups. Conclusions LT is an effective treatment for HBV ‐related end‐stage liver disease. The combination of ETV and intramuscular HBIG for HBV recurrence prophylaxis after LT was more effective than LAM , especially in C hinese patients with HBV recurrence risk factors.