High Viremia, Prolonged Lamivudine Therapy and Recurrent Hepatocellular Carcinoma Predict Posttransplant Hepatitis B Recurrence dagger

Hepatitis B virus (HBV) recurrence following orthotopic liver transplantation (OLT) is generally preventable by prophylaxis with hepatitis B immunoglobulin (HBIG) and lamivudine (LAM). However, HBV recurrence sometimes develops despite prophylaxis. This study assessed posttransplant outcomes and identified predictors of HBV recurrence. We analyzed the outcomes of 209 consecutive patients positive for hepatitis B surface antigen who underwent OLT, who received either combination prophylaxis with HBIG and LAM (89.0%) or HBIG monoprophylaxis (11.0%). The median follow-up was 36.8 months (range, 1.0-84.4). Posttransplant HBV recurrence occurred in 22 patients (10.5%), including 13 patients with drug-resistant mutations. HBV recurrence was observed in six patients after hepatocellular carcinoma (HCC) recurrence. Independent predictors of HBV recurrence were recurrent HCC (p 1.5 years (p = 0.001) and high HBV DNA titers (>= 105 copies/mL) at OLT (p = 0.036). In conclusion, high viremia at OLT and prolonged exposure to LAM should be further stressed as main predictors of HBV recurrence.Faria LC, 2008, GASTROENTEROLOGY, V134, P1890, DOI 10.1053/j.gastro.2008.02.064FARIA LC, 2008, GASTROENTEROLOGY, V134, P2155Wong SN, 2007, LIVER TRANSPLANT, V13, P334, DOI 10.1002/lt.20959Yi NJ, 2007, LIVER TRANSPLANT, V13, P451, DOI 10.1002/lt.21043Woo HY, 2007, ANTIVIR THER, V12, P7Lo CM, 2005, AM J TRANSPLANT, V5, P1893, DOI 10.1111/j.1600-6143.2005.00952.xTerrault N, 2005, LIVER TRANSPLANT, V11, P716, DOI 10.1002/lt.20492Marzano A, 2005, LIVER TRANSPLANT, V11, P402, DOI 10.1002/lt.20402Song BC, 2005, INTERVIROLOGY, V48, P133, DOI 10.1159/000081740Neff GW, 2004, LIVER TRANSPLANT, V10, P1372, DOI 10.1002/lt.20277Kim WR, 2004, LIVER TRANSPLANT, V10, P968, DOI 10.1002/lt.20217Hong SP, 2004, J HEPATOL, V40, P837, DOI 10.1016/j.jhep.2004.01.006Roche B, 2003, HEPATOLOGY, V38, P86, DOI 10.1053/jhep.2003.50294Locarnini S, 2003, SEMIN LIVER DIS, V23, P5Yao FY, 2002, LIVER TRANSPLANT, V8, P765, DOI 10.1053/jlts.2002.34892Steinmuller T, 2002, HEPATOLOGY, V35, P1528, DOI 10.1053/jhep.2002.33681Bock CT, 2002, GASTROENTEROLOGY, V122, P264, DOI 10.1053/gast.2002.31015Rosenau J, 2001, J HEPATOL, V34, P895Marzano A, 2001, J HEPATOL, V34, P903Perrillo RP, 2001, HEPATOLOGY, V33, P424, DOI 10.1053/jhep.2001.21554Han SHB, 2000, LIVER TRANSPLANT, V6, P741Mutimer D, 2000, TRANSPLANTATION, V70, P809Angus PW, 2000, LIVER TRANSPLANT, V6, P429Malkan G, 2000, TRANSPLANTATION, V69, P1403Terrault NA, 1998, HEPATOLOGY, V28, P555Trautwein C, 1996, HEPATOLOGY, V24, P482WONG PYN, 1995, AM J GASTROENTEROL, V90, P29SAMUEL D, 1993, NEW ENGL J MED, V329, P1842OGRADY JG, 1992, J HEPATOL, V14, P104SAMUEL D, 1991, LANCET, V337, P813TODO S, 1991, HEPATOLOGY, V13, P619