Buti Maria, Mas Antoni, Prieto Martin, Casafont Fernando, González Antonio, Miras Manuel, Herrero Jose Ignacio, Jardi Rosendo, Esteban Rafael
Hospital General Valle de Hebrón and CIBER EHD, Barcelona, Spain. mbuti@vhebronnet
Transplantation. 2007 Sep 15;84(5):650-4. doi: 10.1097/01.tp.0000277289.23677.0a.
Lamivudine combined with hepatitis B immune globulin (HBIg) is the standard of care for preventing the recurrence hepatitis B virus after liver transplant. To determine the risk of hepatitis B virus (HBV) recurrence after early withdrawal of HBIg in patients receiving lamivudine maintenance therapy, 20 patients receiving a course of HBIg and lamivudine after transplantation and long-term maintenance therapy with lamivudine and 9 patients receiving HBIg and lamivudine indefinitely were analyzed. The survival rate was 90% after a mean follow-up of 83 months. The HBV recurrence rate was 14% with a mean period of 91 months free from HBV recurrence. Both groups had similar HBV recurrence rates, 15% for the combination and 11% for lamivudine alone. Four patients, 3 of whom were noncompliant with therapy, experienced posttransplant HBV recurrence. Patients who adhere to long-term prophylaxis with lamivudine after early withdrawal of HBIg have a low risk of HBV recurrence, similar to those who receive combination prophylaxis.
拉米夫定联合乙型肝炎免疫球蛋白（HBIg）是预防肝移植后乙型肝炎病毒复发的标准治疗方案。为了确定接受拉米夫定维持治疗的患者早期停用HBIg后乙型肝炎病毒（HBV）复发的风险，对20例移植后接受一个疗程HBIg和拉米夫定并长期接受拉米夫定维持治疗的患者以及9例无限期接受HBIg和拉米夫定治疗的患者进行了分析。平均随访83个月后的生存率为90%。HBV复发率为14%，平均无HBV复发期为91个月。两组的HBV复发率相似，联合治疗组为15%，单独使用拉米夫定组为11%。4例患者出现移植后HBV复发，其中3例未坚持治疗。早期停用HBIg后坚持长期使用拉米夫定预防的患者HBV复发风险较低，与接受联合预防的患者相似。
