Evolving strategies to prevent HBV recurrence

[Guest guest]

Liver Transpl. 2004 Oct;10 Suppl 10:S74.

Evolving strategies to prevent HBV recurrence.

Roche B, D.

Centre Hepatobiliaire, Hopital Brousse, Villejuif, France.

Key Points 1Long-term prophylaxis with hepatitis B immune globulin (HBIG)

significantly reduces the risk for hepatitis B virus (HBV) recurrence and

increases survival. Patients with HBV cirrhosis and / or positive HBV DNA at

the time of transplantation have a high risk for recurrence despite HBIG

prophylaxis.2Pre-orthotopic liver transplantation (OLT) antiviral treatment

using lamivudine (LAM) can suppress HBV replication before transplantation

and may induce clinical improvement in a subset of patients. Adefovir

dipivoxil (ADV) may serve as " rescue " therapy for patients with LAM

resistance; its place as first-line therapy requires further

evaluation.3Combination prophylaxis with LAM and HBIG prevents HBV

recurrence in 90% to 100% of patients who undergo transplantation for

hepatitis B. The optimal HBIG protocol in the " nucleoside-nucleotide analog

era " remains to be determined. The place of ADV or LAM as first-line

posttransplant antiviral therapy in combination with HBIG requires further

studies.4Future research should test new protocols using lower HBIG doses

given intravenously (IV) or intramuscularly (IM) alone or in combination

with antiviral agents and identify patients in whom HBIG prophylaxis can be

stopped safely or replaced by antiviral agents or vaccination. (Liver

Transpl 2004;10:S74-S85.)

PMID: 15382222 [PubMed - in process]

[Guest guest]

Liver Transpl. 2004 Oct;10 Suppl 10:S74.

Evolving strategies to prevent HBV recurrence.

Roche B, D.

Centre Hepatobiliaire, Hopital Brousse, Villejuif, France.

Key Points 1Long-term prophylaxis with hepatitis B immune globulin (HBIG)

significantly reduces the risk for hepatitis B virus (HBV) recurrence and

increases survival. Patients with HBV cirrhosis and / or positive HBV DNA at

the time of transplantation have a high risk for recurrence despite HBIG

prophylaxis.2Pre-orthotopic liver transplantation (OLT) antiviral treatment

using lamivudine (LAM) can suppress HBV replication before transplantation

and may induce clinical improvement in a subset of patients. Adefovir

dipivoxil (ADV) may serve as " rescue " therapy for patients with LAM

resistance; its place as first-line therapy requires further

evaluation.3Combination prophylaxis with LAM and HBIG prevents HBV

recurrence in 90% to 100% of patients who undergo transplantation for

hepatitis B. The optimal HBIG protocol in the " nucleoside-nucleotide analog

era " remains to be determined. The place of ADV or LAM as first-line

posttransplant antiviral therapy in combination with HBIG requires further

studies.4Future research should test new protocols using lower HBIG doses

given intravenously (IV) or intramuscularly (IM) alone or in combination

with antiviral agents and identify patients in whom HBIG prophylaxis can be

stopped safely or replaced by antiviral agents or vaccination. (Liver

Transpl 2004;10:S74-S85.)

PMID: 15382222 [PubMed - in process]

[Guest guest]

Liver Transpl. 2004 Oct;10 Suppl 10:S74.

Evolving strategies to prevent HBV recurrence.

Roche B, D.

Centre Hepatobiliaire, Hopital Brousse, Villejuif, France.

Key Points 1Long-term prophylaxis with hepatitis B immune globulin (HBIG)

significantly reduces the risk for hepatitis B virus (HBV) recurrence and

increases survival. Patients with HBV cirrhosis and / or positive HBV DNA at

the time of transplantation have a high risk for recurrence despite HBIG

prophylaxis.2Pre-orthotopic liver transplantation (OLT) antiviral treatment

using lamivudine (LAM) can suppress HBV replication before transplantation

and may induce clinical improvement in a subset of patients. Adefovir

dipivoxil (ADV) may serve as " rescue " therapy for patients with LAM

resistance; its place as first-line therapy requires further

evaluation.3Combination prophylaxis with LAM and HBIG prevents HBV

recurrence in 90% to 100% of patients who undergo transplantation for

hepatitis B. The optimal HBIG protocol in the " nucleoside-nucleotide analog

era " remains to be determined. The place of ADV or LAM as first-line

posttransplant antiviral therapy in combination with HBIG requires further

studies.4Future research should test new protocols using lower HBIG doses

given intravenously (IV) or intramuscularly (IM) alone or in combination

with antiviral agents and identify patients in whom HBIG prophylaxis can be

stopped safely or replaced by antiviral agents or vaccination. (Liver

Transpl 2004;10:S74-S85.)

PMID: 15382222 [PubMed - in process]

[Guest guest]

Liver Transpl. 2004 Oct;10 Suppl 10:S74.

Evolving strategies to prevent HBV recurrence.

Roche B, D.

Centre Hepatobiliaire, Hopital Brousse, Villejuif, France.

Key Points 1Long-term prophylaxis with hepatitis B immune globulin (HBIG)

significantly reduces the risk for hepatitis B virus (HBV) recurrence and

increases survival. Patients with HBV cirrhosis and / or positive HBV DNA at

the time of transplantation have a high risk for recurrence despite HBIG

prophylaxis.2Pre-orthotopic liver transplantation (OLT) antiviral treatment

using lamivudine (LAM) can suppress HBV replication before transplantation

and may induce clinical improvement in a subset of patients. Adefovir

dipivoxil (ADV) may serve as " rescue " therapy for patients with LAM

resistance; its place as first-line therapy requires further

evaluation.3Combination prophylaxis with LAM and HBIG prevents HBV

recurrence in 90% to 100% of patients who undergo transplantation for

hepatitis B. The optimal HBIG protocol in the " nucleoside-nucleotide analog

era " remains to be determined. The place of ADV or LAM as first-line

posttransplant antiviral therapy in combination with HBIG requires further

studies.4Future research should test new protocols using lower HBIG doses

given intravenously (IV) or intramuscularly (IM) alone or in combination

with antiviral agents and identify patients in whom HBIG prophylaxis can be

stopped safely or replaced by antiviral agents or vaccination. (Liver

Transpl 2004;10:S74-S85.)

PMID: 15382222 [PubMed - in process]