BACKGROUND: Hepatitis B virus (HBV) recurrence after a liver transplant (LT) is a global issue. Several strategies have been adopted to prevent this recurrence. Most strategies recommend a combination of hepatitis B immunoglobulin (HBIG) and or nucleos(t)ide analogue. AIM OF THE STUDY: The aim of the study is to determine the anti-HBs response to HBIG among Indian patients who had undetectable pre-transplant HBV DNA. METHODS: Seven adult HBV-related LT recipients of Indian origin with low pre-transplant HBV titres who had a liver transplant between August 2009 and June 2012 were included in the study. The protocol followed for post-liver transplant HBIG dose was titrated to achieve an anti-HBs titre of at least 100 IU/L. All recipients were on entecavir. Anti-HBs titre, and HBsAg status was checked at regular intervals. A retrospective analysis of the anti-HBs response to a loading and maintenance dose of HBIG was done. RESULTS: Seven adult HBV-related LT recipients on post-transplant prophylaxis with HBIG and nucleoside analogue (entecavir) fulfilled the criteria for the study. The median anti-HBs response to the anhepatic and loading dose of HBIG was high at 555 IU/L. In two, the response was less than 100 IU/L. The median dose of HBIG reduced at end of 1 month to 800 IU, and the median titre was 223 IU/L. For the next 11 months, the median requirement of HBIG was 3,000 and 4,000 IU, and the titre was low at 53.8 and 60.9 IU/L at end of 6 and 12 months, respectively. CONCLUSIONS: The anti-HBs response to HBIG was variable, and titres even below 100 IU/L did not result in HBV recurrence when HBIG was given in combination with entecavir.
BACKGROUND:Hepatitis B virus (HBV) recurrence after a liver transplant (LT) is a global issue. Several strategies have been adopted to prevent this recurrence. Most strategies recommend a combination of hepatitis B immunoglobulin (HBIG) and or nucleos(t)ide analogue. AIM OF THE STUDY: The aim of the study is to determine the anti-HBs response to HBIG among Indian patients who had undetectable pre-transplant HBV DNA. METHODS: Seven adult HBV-related LT recipients of Indian origin with low pre-transplant HBV titres who had a liver transplant between August 2009 and June 2012 were included in the study. The protocol followed for post-liver transplant HBIG dose was titrated to achieve an anti-HBs titre of at least 100 IU/L. All recipients were on entecavir. Anti-HBs titre, and HBsAg status was checked at regular intervals. A retrospective analysis of the anti-HBs response to a loading and maintenance dose of HBIG was done. RESULTS: Seven adult HBV-related LT recipients on post-transplant prophylaxis with HBIG and nucleoside analogue (entecavir) fulfilled the criteria for the study. The median anti-HBs response to the anhepatic and loading dose of HBIG was high at 555 IU/L. In two, the response was less than 100 IU/L. The median dose of HBIG reduced at end of 1 month to 800 IU, and the median titre was 223 IU/L. For the next 11 months, the median requirement of HBIG was 3,000 and 4,000 IU, and the titre was low at 53.8 and 60.9 IU/L at end of 6 and 12 months, respectively. CONCLUSIONS: The anti-HBs response to HBIG was variable, and titres even below 100 IU/L did not result in HBV recurrence when HBIG was given in combination with entecavir.
Authors: N A Terrault; S Zhou; C Combs; J A Hahn; J R Lake; J P Roberts; N L Ascher; T L Wright Journal: Hepatology Date: 1996-12 Impact factor: 17.425
Authors: James Fung; Cindy Cheung; See-Ching Chan; Man-Fung Yuen; Kenneth S H Chok; William Sharr; Wing-Chiu Dai; Albert C Y Chan; Tan-To Cheung; Simon Tsang; Banny Lam; Ching-Lung Lai; Chung-Mau Lo Journal: Gastroenterology Date: 2011-07-14 Impact factor: 22.682
Authors: D Samuel; A Bismuth; D Mathieu; J L Arulnaden; M Reynes; J P Benhamou; C Brechot; H Bismuth Journal: Lancet Date: 1991-04-06 Impact factor: 79.321
Authors: A Marzano; M Salizzoni; W Debernardi-Venon; A Smedile; A Franchello; A Ciancio; E Gentilcore; P Piantino; A M Barbui; E David; F Negro; M Rizzetto Journal: J Hepatol Date: 2001-06 Impact factor: 25.083
Authors: Edward J Gane; Peter W Angus; Simone Strasser; Darrell H G Crawford; John Ring; Gary P Jeffrey; Geoffrey W McCaughan Journal: Gastroenterology Date: 2007-01-05 Impact factor: 22.682