Dooghaie Moghadam Arash, Eslami Pegah, Dowlati Beirami Amirreza, Iravani Shahrokh, Farokhi Ermia, Mansour-Ghanaei Alireza, Hashemi Mahmood Reza, Aghajanpoor Pasha Morteza, Mehrvar Azim, Nassiri-Toosi Mohssen
Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran.
Middle East J Dig Dis. 2021 Jan;13(1):5-14. doi: 10.34172/mejdd.2021.197. Epub 2021 Mar 2.
Currently, liver transplantation (LT) is considered as the only option for the treatment of patients with various causes of liver failure, including patients with chronic hepatitis B virus (HBV) infections. Overall, patients with HBV who undergo LT are at increased risk of hepatitis B infection recurrence. Although the current knowledge regarding the pathophysiology of this infection has been dramatically increased over the past few decades, it is still considered a complex disease process with varying degrees of clinical characteristics and changing patterns over time. There are various treatment strategies for preventing HBV recurrence in the LT setting. Generally, these regimens include oral nucleoside/ nucleotide analogues (NAs), hepatitis B immune globulin (HBIG), and vaccines or the combination of these drugs. The treatment strategy of choice should be based on cost-effectiveness, along with other patients underlying conditions. In this case, studies indicate that potent NAs are more cost-effective than HBIG in most case scenarios. In this article, we aimed to review the general medications used in the prophylaxis of the recurrence of HBV infection after LT.
目前,肝移植(LT)被认为是治疗各种原因导致的肝衰竭患者的唯一选择,包括慢性乙型肝炎病毒(HBV)感染患者。总体而言,接受肝移植的HBV患者乙肝感染复发风险增加。尽管在过去几十年里,关于这种感染病理生理学的现有知识有了显著增加,但它仍被认为是一个复杂的疾病过程,具有不同程度的临床特征且随时间变化。在肝移植环境中,有多种预防HBV复发的治疗策略。一般来说,这些方案包括口服核苷/核苷酸类似物(NAs)、乙肝免疫球蛋白(HBIG)、疫苗或这些药物的联合使用。选择的治疗策略应基于成本效益以及患者的其他基础状况。在这种情况下,研究表明在大多数情况下,强效NAs比HBIG更具成本效益。在本文中,我们旨在综述肝移植后预防HBV感染复发常用的药物。