We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Hepatitis B virus quasispecies evolution after liver transplantation in patients under long-term lamivudine prophylaxis with or without hepatitis B immune globulin.
- Authors
Buti, M.; Tabernero, D.; Mas, A.; Homs, M.; Prieto, M.; Rodríguez‐Frías, F.; Casafont, F.; Casillas, R.; González, A.; Miras, M.; Herrero, J.I.; Castells, L.; Esteban, R.
- Abstract
Aims To investigate an optimal long-term prophylactic strategy for prevention of hepatitis B virus (HBV) recurrence after liver transplantation, we conducted a randomized study of 29 transplant recipients receiving a short course of hepatitis B immune globulin ( HBIg) + lamivudine ( LAM), followed by randomization to long-term prophylaxis with LAM with or without HBIg. Methods The efficacy and safety, and impact on survival and HBV recurrence of these 2 prophylactic regimens were compared over a mean period of 10 years. In patients with viral recurrence, the HBV quasispecies in the surface/polymerase region were studied by ultra-deep pyrosequencing ( UDPS). Results The 10-year survival rate was 76% and was not affected by the type of prophylaxis. Four patients had hepatitis B surface antigen ( HBsAg) recurrence within the first 48 months after orthotopic liver transplantation ( OLT). HBsAg-positive and -negative patients showed similar mean survival times, with no differences between the 2 regimens. Low HBV DNA levels were transiently detected in 32% of HBsAg-negative patients. UDPS showed major changes after OLT in the HBV quasispecies of patients with viral recurrence, which may be explained by a 'bottleneck' effect of OLT together with prophylactic therapy. Conclusion Long-term survival after OLT in end-stage chronic hepatitis B patients was good with both prophylactic strategies. However, low, transient HBV DNA levels were detected even in the absence of HBsAg, showing the importance of continuing HBV prophylaxis.
- Subjects
LIVER transplantation; HEPATITIS B virus; HEPATITIS B prevention; INTRAVENOUS immunoglobulins; PYROSEQUENCING
- Publication
Transplant Infectious Disease, 2015, Vol 17, Issue 2, p208
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.12360