Evangelos Cholongitas, Theodora Oikonomou, Konstantina Bafa, Emmanouil Sinakos, George V Papatheodoridis, Ioannis Goulis
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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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23316,"journal":{"name":"Transplantation","volume":null,"pages":null},"PeriodicalIF":5.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of Newer Nucleos(t)ide Analogs After Hepatitis B Immunoglobulin Discontinuation Against Hepatitis B and D Recurrence in Liver Transplant Recipients.\",\"authors\":\"Evangelos Cholongitas, Theodora Oikonomou, Konstantina Bafa, Emmanouil Sinakos, George V Papatheodoridis, Ioannis Goulis\",\"doi\":\"10.1097/TP.0000000000005027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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). 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引用次数: 0
摘要
背景:恩替卡韦(entecavir)和替诺福韦(tenofovir)等具有高耐药基因屏障的核苷(t)ide类似物(NAs)的使用提高了肝移植(LT)后乙型肝炎病毒(HBV)复发的抗病毒预防疗效。然而,乙型肝炎免疫球蛋白(HBIG)的最佳给药时间和剂量仍存在争议,尤其是对于因 HBV 和 D 型肝炎病毒(HDV)合并感染而接受移植的患者:我们对 28 名因 HBV/HDV 肝硬化而接受移植的患者进行了评估。LT后,每位患者在6个月内接受低剂量HBIG加NA的固定方案,然后继续接受长期NA预防治疗(恩替卡韦:8例,替诺福韦:20例):在72个月的随访期间,1例(3.6%)患者在停用HBIG后33个月再次出现低滴度乙肝表面抗原,在单剂量HBIG 1000 IU/L后转阴,而血清HBV DNA和HDV RNA仍持续检测不到,没有任何HBV/HDV复发的临床或生化证据:我们首次展示了短期、固定的小剂量 HBIG 加 NA 后长期 NA 单一预防方案对防止 LT 后 HBV/HDV 复发的疗效,但在停用 HBIG 后仍需进行仔细的随访,同时还需要更大规模的研究来证实这些发现。
Efficacy of Newer Nucleos(t)ide Analogs After Hepatitis B Immunoglobulin Discontinuation Against Hepatitis B and D Recurrence in Liver Transplant Recipients.
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.
期刊介绍:
The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year.
Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal.
Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed.
The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.