Am J Gastroenterol. 2013 Jun;108(6):949-51. doi: 10.1038/ajg.2013.122.
Improvements in the outcomes of patients transplanted for hepatitis B virus (HBV) have been substantial in the past two decades. With current therapies, the vast majority of transplant recipients are protected against recurrent and/or progressive liver disease. Effective prophylactic therapies include hepatitis B immune globulin (HBIG) plus nucleos(t)ide analogues (NAs) and NA therapy alone (without HBIG). Definitions of recurrence in the setting of prophylaxis are evolving--persistence or reappearance of hepatitis B surface antigen in serum remains a marker of reinfection, but is not necessarily a marker of progressive hepatitis. The level of HBV DNA at the time of transplant remains the most consistent factor predicting risk of recurrent HBV. An individualized, rather than a "one size fits all", approach to prophylaxis that is based on risk of reinfection and/or risk of progressive disease, if reinfected, is the optimal means of insuring optimal graft survival for HBV-infected patients.
在过去的二十年中，乙型肝炎病毒 (HBV) 移植患者的治疗效果有了显著提高。通过目前的治疗方法，绝大多数移植受者可以免受复发性和/或进行性肝病的侵害。有效的预防性治疗包括乙型肝炎免疫球蛋白 (HBIG) 加核苷（酸）类似物 (NAs) 和单独使用 NA 治疗（不使用 HBIG）。在预防措施的背景下，对复发的定义正在不断发展——血清中乙型肝炎表面抗原的持续存在或再次出现仍然是再感染的标志物，但不一定是进行性肝炎的标志物。移植时 HBV DNA 的水平仍然是预测复发性 HBV 风险的最一致因素。根据再感染和/或如果再感染时发生进行性疾病的风险，对预防措施采取个体化而非“一刀切”的方法是确保 HBV 感染患者最佳移植物存活的最佳手段。
