Combination therapy with lamivudine and low dose hepatitis-B immune globulin against hepatitis-B recurrence after liver transplantation
Küçük Resim Yok
Tarih
2000
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background/aims: Orthotopic liver transplantation, in patients with hepatitis B virus infection, is associated with a high reinfection rate. Viral breakthrough and resistance are significant problems with monotherapy with either hepatitis B immune globulin or lamivudine for prophylaxis against hepatitis B recurrence. Combination therapy with lamivudine and hepatitis B immune globulin has been suggested, but one of the most important disadvantages is the high cost of hepatitis B immune globulin. The aim of this study was to evaluate the efficacy and safety of combination therapy with low dose hepatitis B immune globulin and lamivudine for prophylaxis. Methods: Twelve patients with hepatitis B virus cirrhosis were included in the study. Three patients commenced lamivudine (150mg/daily) for HBV DNA positivity before transplantation while the remaining nine patients commenced it at the same dosage on the first day of transplantation. All patients were HBV DNA negative at the time of transplantation. Hepatitis B immune globulinwas given in our protocol as follows: 1000 IU intravenously and 1000 IU intramuscularly during the anhepatic phase of the transplantation, followed by 800 IU intramuscularly for the next two days and then 400 IU intramuscularly every other day in the first week. Four hundred IU intramuscularly was then given twice weekly while the patient was still in hospital, followed by 400 IU intramuscularly every two weeks until stabilization and followed by 400 IU intramuscularly every three weeks or month. The median duration of hospital stay was 21 days (range 14-45 days). Results: One patient died on the second postoperative day due to primary nonfunction. The remaining 11 patients were HBsAg and hepatitis B virus DNA negative for a median of 545 days (range 180-900) by polmerase chain reaction. Conclusions: Combination therapy with low dose hepatitis B immune globulin and lamivudine is highly effective against hepatitis B recurrence at a median follow up of 545 days (1.5 years). Longer follow up with more patients in multicenter prospective randomized trials will give more accurate results.
Açıklama
Anahtar Kelimeler
Chronic hepatitis B, Hepatitis B immune globuline, Lamivudine, Liver transplantation
Kaynak
Turkish Journal of Gastroenterology
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
11
Sayı
3
