Departments of Gastroenterology and Hepatology Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Hepatol Res. 2013 Jan;43(1):67-71. doi: 10.1111/j.1872-034X.2012.01020.x. Epub 2012 May 1.
Hepatitis B recurrence after liver transplantation can be reduced to less than 10% by combination therapy with lamivudine (LAM) and hepatitis B immunoglobulin (HBIG). The aim of this study was to evaluate the efficacy and safety of prophylaxis with entecavir (ETV), which has higher efficacy and lower resistance rates than LAM, combined with HBIG in preventing hepatitis B recurrence after living-donor liver transplantation (LDLT).
Twenty-six patients who received ETV plus HBIG (ETV group) after LDLT for hepatitis B virus (HBV)-related end-stage liver disease were analyzed by comparing with 63 control patients who had received LAM plus HBIG (LAM group).
The survival rates of the patients treated with ETV plus HBIG was 73% after both 1 and 3 years, and there was no statistical difference between the patients in the ETV group and LAM group. No HBV recurrence was detected during the median follow-up period of 25.1 months in the ETV group, whereas the HBV recurrence rate was 4% at 3 years and 6% at 5 years in the LAM group. No patients had adverse effects related to ETV administration.
ETV combined with HBIG provides effective and safe prophylaxis in preventing hepatitis B recurrence after LDLT.
拉米夫定（LAM）联合乙型肝炎免疫球蛋白（HBIG）的联合治疗可将肝移植后乙型肝炎（HBV）复发率降低至 10%以下。本研究旨在评估恩替卡韦（ETV）联合 HBIG 预防活体供肝移植（LDLT）后 HBV 复发的疗效和安全性，ETV 的疗效优于 LAM，耐药率更低。
分析 26 例接受 ETV 联合 HBIG（ETV 组）治疗的 LDLT 后 HBV 相关终末期肝病患者，并与 63 例接受 LAM 联合 HBIG（LAM 组）治疗的患者进行比较。
ETV 联合 HBIG 治疗患者的 1 年和 3 年生存率分别为 73%，两组患者无统计学差异。在 ETV 组的中位随访 25.1 个月期间未检测到 HBV 复发，而 LAM 组的 HBV 复发率为 3 年时 4%，5 年时 6%。无患者出现与 ETV 治疗相关的不良反应。
ETV 联合 HBIG 可有效预防 LDLT 后 HBV 复发，且安全有效。
