Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
Hepatobiliary Pancreat Dis Int. 2013 Apr;12(2):149-53. doi: 10.1016/s1499-3872(13)60024-7.
Lamivudine and hepatitis B immunoglobulin (HBIG) are widely used to treat patients with hepatitis B recurrence after liver transplantation. However, the outcomes are inconclusive. The present study was undertaken to evaluate the effect of combined therapy on patients with hepatitis B recurrence after liver transplantation.
Twenty-two patients with hepatitis B recurrence after liver transplantation from August 2000 to October 2011 were enrolled in this study. Of these patients, 16 received lamivudine plus HBIG (combination therapy group) and 6 were treated with lamivudine alone (lamivudine-treated group). The clinical features were matched in the two groups. HBV recurrence parameters, HBsAg clearance rate, patient survival rate, and survival time were compared.
The average time of follow-up was 47.2 months (range 13-99). Significant difference was noted in the HBsAg clearance rate in the lamivudine-treated and combination therapy groups (50% vs 93.8%, P<0.05). There was no significant difference in the time of HBV recurrence, patient survival rate and survival time between lamivudine-treated and combination therapy groups (P>0.05).
Compared with lamivudine monotherapy, combination therapy significantly increased the HBsAg clearance rate in patients with HBV recurrence after liver transplantation.
拉米夫定和乙型肝炎免疫球蛋白（HBIG）广泛用于治疗肝移植后乙型肝炎复发的患者。然而，其效果尚无定论。本研究旨在评估联合治疗对肝移植后乙型肝炎复发患者的疗效。
本研究纳入了 2000 年 8 月至 2011 年 10 月期间 22 例肝移植后乙型肝炎复发的患者。其中 16 例接受拉米夫定联合 HBIG（联合治疗组），6 例接受拉米夫定单药治疗（拉米夫定治疗组）。两组的临床特征相匹配。比较两组患者的乙型肝炎病毒（HBV）复发参数、HBsAg 清除率、患者生存率和生存时间。
平均随访时间为 47.2 个月（范围 13-99）。拉米夫定治疗组和联合治疗组的 HBsAg 清除率差异有统计学意义（50%比 93.8%，P<0.05）。拉米夫定治疗组和联合治疗组的 HBV 复发时间、患者生存率和生存时间差异无统计学意义（P>0.05）。
与拉米夫定单药治疗相比，联合治疗可显著提高肝移植后乙型肝炎复发患者的 HBsAg 清除率。
