Liver transplantation for hepatitis B

[Guest guest]

Hepatol Res. 2004 Aug;29(4):193-201.

Liver transplantation for hepatitis B.

Bui Han SH, P.

Division of Digestive Diseases, Geffen School of Medicine at UCLA, Los

Angeles, CA, USA.

Recurrent HBV is almost universal post-LT and is accompanied by significant

graft and patient loss in the absence of effective immunoprophylaxis.

Hepatitis B immunoglobulin (HBIG) monotherapy and lamivudine monotherapy

significantly reduce the rate of recurrent hepatitis B, but recurrent

hepatitis B still occurs in up to 25% due to the emergence of resistant

mutants. Combination administration of HBIG and lamivudine is more

efficacious in preventing recurrent hepatitis B, decreasing recurrence rates

of hepatitis B to 0-18% in studies. Future studies to determine the optimal

dosing regimen and duration of HBIG and lamivudine and to evaluate the

efficacy of newer antivirals such as adefovir dipivoxil in preventing

recurrent HBV are needed. Treatment of established recurrent hepatitis B

remains problematic. Lamivudine has shown promise during the initial

treatment period, but is plagued by rapid development of viral resistance

with longer treatment duration. Adefovir dipivoxil appears very promising,

and further studies are needed to evaluate its efficacy in the post-liver

transplant patient. Interferon-alfa's use in the post-liver transplant

patient is limited given the availability of the newer antiviral drugs.

Famciclovir and ganciclovir have shown some promise in treating recurrent

HBV, but have been replaced by newer agents such as lamivudine and adefovir.

PMID: 15288010 [PubMed - as supplied by publisher]

[Guest guest]

Hepatol Res. 2004 Aug;29(4):193-201.

Liver transplantation for hepatitis B.

Bui Han SH, P.

Division of Digestive Diseases, Geffen School of Medicine at UCLA, Los

Angeles, CA, USA.

Recurrent HBV is almost universal post-LT and is accompanied by significant

graft and patient loss in the absence of effective immunoprophylaxis.

Hepatitis B immunoglobulin (HBIG) monotherapy and lamivudine monotherapy

significantly reduce the rate of recurrent hepatitis B, but recurrent

hepatitis B still occurs in up to 25% due to the emergence of resistant

mutants. Combination administration of HBIG and lamivudine is more

efficacious in preventing recurrent hepatitis B, decreasing recurrence rates

of hepatitis B to 0-18% in studies. Future studies to determine the optimal

dosing regimen and duration of HBIG and lamivudine and to evaluate the

efficacy of newer antivirals such as adefovir dipivoxil in preventing

recurrent HBV are needed. Treatment of established recurrent hepatitis B

remains problematic. Lamivudine has shown promise during the initial

treatment period, but is plagued by rapid development of viral resistance

with longer treatment duration. Adefovir dipivoxil appears very promising,

and further studies are needed to evaluate its efficacy in the post-liver

transplant patient. Interferon-alfa's use in the post-liver transplant

patient is limited given the availability of the newer antiviral drugs.

Famciclovir and ganciclovir have shown some promise in treating recurrent

HBV, but have been replaced by newer agents such as lamivudine and adefovir.

PMID: 15288010 [PubMed - as supplied by publisher]

[Guest guest]

Hepatol Res. 2004 Aug;29(4):193-201.

Liver transplantation for hepatitis B.

Bui Han SH, P.

Division of Digestive Diseases, Geffen School of Medicine at UCLA, Los

Angeles, CA, USA.

Recurrent HBV is almost universal post-LT and is accompanied by significant

graft and patient loss in the absence of effective immunoprophylaxis.

Hepatitis B immunoglobulin (HBIG) monotherapy and lamivudine monotherapy

significantly reduce the rate of recurrent hepatitis B, but recurrent

hepatitis B still occurs in up to 25% due to the emergence of resistant

mutants. Combination administration of HBIG and lamivudine is more

efficacious in preventing recurrent hepatitis B, decreasing recurrence rates

of hepatitis B to 0-18% in studies. Future studies to determine the optimal

dosing regimen and duration of HBIG and lamivudine and to evaluate the

efficacy of newer antivirals such as adefovir dipivoxil in preventing

recurrent HBV are needed. Treatment of established recurrent hepatitis B

remains problematic. Lamivudine has shown promise during the initial

treatment period, but is plagued by rapid development of viral resistance

with longer treatment duration. Adefovir dipivoxil appears very promising,

and further studies are needed to evaluate its efficacy in the post-liver

transplant patient. Interferon-alfa's use in the post-liver transplant

patient is limited given the availability of the newer antiviral drugs.

Famciclovir and ganciclovir have shown some promise in treating recurrent

HBV, but have been replaced by newer agents such as lamivudine and adefovir.

PMID: 15288010 [PubMed - as supplied by publisher]

[Guest guest]

Hepatol Res. 2004 Aug;29(4):193-201.

Liver transplantation for hepatitis B.

Bui Han SH, P.

Division of Digestive Diseases, Geffen School of Medicine at UCLA, Los

Angeles, CA, USA.

Recurrent HBV is almost universal post-LT and is accompanied by significant

graft and patient loss in the absence of effective immunoprophylaxis.

Hepatitis B immunoglobulin (HBIG) monotherapy and lamivudine monotherapy

significantly reduce the rate of recurrent hepatitis B, but recurrent

hepatitis B still occurs in up to 25% due to the emergence of resistant

mutants. Combination administration of HBIG and lamivudine is more

efficacious in preventing recurrent hepatitis B, decreasing recurrence rates

of hepatitis B to 0-18% in studies. Future studies to determine the optimal

dosing regimen and duration of HBIG and lamivudine and to evaluate the

efficacy of newer antivirals such as adefovir dipivoxil in preventing

recurrent HBV are needed. Treatment of established recurrent hepatitis B

remains problematic. Lamivudine has shown promise during the initial

treatment period, but is plagued by rapid development of viral resistance

with longer treatment duration. Adefovir dipivoxil appears very promising,

and further studies are needed to evaluate its efficacy in the post-liver

transplant patient. Interferon-alfa's use in the post-liver transplant

patient is limited given the availability of the newer antiviral drugs.

Famciclovir and ganciclovir have shown some promise in treating recurrent

HBV, but have been replaced by newer agents such as lamivudine and adefovir.

PMID: 15288010 [PubMed - as supplied by publisher]