Yuting Yang1, Ailong Huang2, Yao Zhao3. 1. Pediatric Research Institute, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China. 2. Institute for Viral Hepatitis, Ministry of Education Key Laboratory of Molecular Biology On Infectious Diseases, Chongqing Medical University, Chongqing, People's Republic of China. 3. Pediatric Research Institute, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, 400014, People's Republic of China. Zhaoy@cqmu.edu.cn.
Abstract
BACKGROUND AND AIM: There is an increased awareness of de novo hepatitis B virus (HBV) infection (DNH) in hepatitis B surface antigen (HBsAg)-negative recipients receiving hepatitis B core antibody (HBcAb)-positive liver organ. Whether hepatitis B surface antibody (HBsAb) has positive result on preventing the occurrence of DNH in HBcAb-positive liver graft recipients remains unknown. A meta-analysis was conducted to evaluate the effect of HBsAb on DNH in these patients. METHODS: We sought published studies through August 29, 2019, in Medline and other sources that examined DNH in liver transplantation receptors with HBcAb-positive grafts. The rate of DNH was established in random-effects model meta-analyses. RESULTS: In 36 studies involving 950 patients, the pooled incidence rate of DNH was 5% in patients with HBsAb positive versus 28.0% HBsAb negative. Prophylactic treatment has a significant impact on the occurrence of DNH in HBsAb-negative patients, no difference in hepatitis B immunoglobulin-combined and nucleos(t)ide analogues (NAs)-alone immunoprophylaxis. Unprotected HBV-naïve patients had the highest risk with DNH. CONCLUSION: Immunoprophylaxis may need more consideration for HBsAb-positive patients receiving HBcAb-positive liver grafts. Active vaccination and mono-prophylaxis with NAs could be recommended in HBsAb-negative recipients against DNH. Further studies should examine the higher genetic barrier drugs for preventing DNH, and the association between DNH and HBV DNA-positive liver graft in this patient population.
BACKGROUND AND AIM: There is an increased awareness of de novo hepatitis B virus (HBV) infection (DNH) in hepatitis B surface antigen (HBsAg)-negative recipients receiving hepatitis B core antibody (HBcAb)-positive liver organ. Whether hepatitis B surface antibody (HBsAb) has positive result on preventing the occurrence of DNH in HBcAb-positive liver graft recipients remains unknown. A meta-analysis was conducted to evaluate the effect of HBsAb on DNH in these patients. METHODS: We sought published studies through August 29, 2019, in Medline and other sources that examined DNH in liver transplantation receptors with HBcAb-positive grafts. The rate of DNH was established in random-effects model meta-analyses. RESULTS: In 36 studies involving 950 patients, the pooled incidence rate of DNH was 5% in patients with HBsAb positive versus 28.0% HBsAb negative. Prophylactic treatment has a significant impact on the occurrence of DNH in HBsAb-negative patients, no difference in hepatitis B immunoglobulin-combined and nucleos(t)ide analogues (NAs)-alone immunoprophylaxis. Unprotected HBV-naïve patients had the highest risk with DNH. CONCLUSION: Immunoprophylaxis may need more consideration for HBsAb-positive patients receiving HBcAb-positive liver grafts. Active vaccination and mono-prophylaxis with NAs could be recommended in HBsAb-negative recipients against DNH. Further studies should examine the higher genetic barrier drugs for preventing DNH, and the association between DNH and HBV DNA-positive liver graft in this patient population.
Entities:
Keywords:
Active vaccination; De novo HBV infection; Effect; Hepatitis B core antibody; Hepatitis B surface antibody; Immunoprophylaxis; Liver transplantation; Meta-analysis; Nucleos(t)ide analogues; Systematic review
Authors: Matthew S Chang; Sonja K Olsen; Elsa M Pichardo; Jessica B Stiles; Lori Rosenthal-Cogan; William D Brubaker; James V Guarrera; Jean C Emond; Robert S Brown Journal: Transplantation Date: 2013-04-15 Impact factor: 4.939
Authors: S Huprikar; L Danziger-Isakov; J Ahn; S Naugler; E Blumberg; R K Avery; C Koval; E D Lease; A Pillai; K E Doucette; J Levitsky; M I Morris; K Lu; J K McDermott; T Mone; J P Orlowski; D M Dadhania; K Abbott; S Horslen; B L Laskin; A Mougdil; V L Venkat; K Korenblat; V Kumar; P Grossi; R D Bloom; K Brown; C N Kotton; D Kumar Journal: Am J Transplant Date: 2015-02-23 Impact factor: 8.086