低剂量乙型肝炎免疫球蛋白联合核苷（酸）类似物预防肝移植后乙型肝炎病毒复发的疗效。

The efficiency of low-dose hepatitis B immunoglobulin plus nucleos(t)ide analogs in preventing posttransplant hepatitis B virus recurrence.

机构信息

Department of Gastroenterology, Atatürk Training and Research Hospital, İzmir Katip Çelebi University, İzmir, Turkey

Department of Liver Transplantation, Kent Hospital, İzmir, Turkey

出版信息

Turk J Med Sci. 2019 Aug 8;49(4):1019-1024. doi: 10.3906/sag-1808-86.

DOI:10.3906/sag-1808-86

PMID:31385669

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7018359/

Abstract

BACKGROUND/AIM: In this study, the efficiency of using low-dose hepatitis B immunoglobulin (HBIG) plus antiviral treatment according to individual needs has been evaluated in posttransplant hepatitis B virus (HBV) patients.

MATERIALS AND METHODS

We retrospectively evaluated 179 patients who were admitted between 2009 and 2014. Five thousand IU intravenous HBIG was given in the anhepatic phase, and 400 IU/day intramuscular (IM) HBIG was given in the posttransplant period. After HBsAg seroconversion, 400 IU IM HBIG was continued as prophylaxis every two weeks.

RESULTS

The average follow-up period was 26 (2–65) months. Seventy patients had hepatocellular carcinoma (HCC). The HBV recurrence was 4.5% in the first year, and 5.8% in the third year. The HBsAg became negative in 11 (2–63) days, and anti-HBs became positive in 9 (1–31) days. HBsAg positivity occurred in 6 patients during the follow-up period. Five of these patients were those who underwent transplantation due to HCC. In 5 of the HCC patients, in whom HBsAg became positive, tumor recurrence was observed after 0.3–9.9 months. HBsAg positivity was more frequently detected in patients with HCC (P = 0.009).

CONCLUSION

The HBV recurrence should be evaluated as a predictor of the HCC recurrence in patients who were transplanted due to HCC.

摘要

背景/目的：在这项研究中，评估了根据个体需求使用低剂量乙型肝炎免疫球蛋白（HBIG）联合抗病毒治疗在移植后乙型肝炎病毒（HBV）患者中的效果。

材料和方法

我们回顾性评估了 2009 年至 2014 年间收治的 179 名患者。在无肝期给予 5000IU 静脉内 HBIG，移植后给予 400IU/天肌内（IM）HBIG。HBsAg 血清转换后，每两周继续给予 400IU IM HBIG 进行预防。

结果

平均随访时间为 26（2-65）个月。70 名患者患有肝细胞癌（HCC）。HBV 复发率在第 1 年为 4.5%，第 3 年为 5.8%。HBsAg 在 11（2-63）天内转为阴性，抗-HBs 在 9（1-31）天内转为阳性。在随访期间，有 6 名患者 HBsAg 阳性。这 5 名患者因 HCC 接受了移植。在 5 例 HCC 患者中，HBsAg 转为阳性后，肿瘤在 0.3-9.9 个月后复发。HBsAg 阳性在 HCC 患者中更为常见（P=0.009）。