TY - JOUR
TI - High Genetic Barrier Nucleos(t)ide Analogue(s) for Prophylaxis From
Hepatitis B Virus Recurrence After Liver Transplantation: A Systematic
Review
AU - Cholongitas, E.
AU - Papatheodoridis, G. V.
JO - American Journal of Transplantation
PY - 2013
VL - 13
TODO - 2
SP - 353-362
PB - Wiley-Blackwell
SN - 1600-6135, 1600-6143
TODO - 10.1111/j.1600-6143.2012.04315.x
TODO - entecavir; Hepatitis B immunoglobulin; lamivudine; liver
transplantation; recurrence HBV infection; tenofovir
TODO - The combination of hepatitis B immunoglobulin (HBIG) and nucleos(t)ide
analogues [NA(s)] is considered as the standard of care for
prophylaxis against HBV recurrence after liver transplantation (LT), but
the optimal protocol is controversial. We evaluated the efficacy of the
newer NAs with high genetic barrier (hgbNA) [i.e. entecavir (ETV) or
tenofovir (TDF)] with or without HBIG as prophylaxis against HBV
recurrence after LT. In total, 519 HBV liver transplant recipients from
17 studies met the inclusion criteria and they were compared to those
under lamivudine (LAM) and HBIG who had been selected in our previous
review. Patients under HBIG and LAM developed HBV recurrence (115/1889
or 6.1%): (a) significantly more frequently compared to patients under
HBIG and a hgbNA [1.0% (3/303), p < 0.001], and (b) numerically but
not significantly more frequently compared to the patients who received
a newer NA after discontinuation of HBIG [3.9% (4/102), p = 0.52].
The use of a hgbNA without any HBIG offered similar antiviral
prophylaxis compared to HBIG and LAM combination, if the definition of
HBV recurrence was based on HBV DNA detectability [0.9% vs. 3.8%, p
= 0.11]. Our findings favor the use of HBIG and a hgbNA instead of HBIG
and LAM combined prophylaxis against HBV recurrence after LT.
ER -