Prevention Of Hepatitis B Recurrence After Liver Transplantation Using Lamivudine Or Lamivudine Combined With Hepatitis B Immunoglobulin Prophylaxis

Background The aim of our study was to determine the outcomes of livertransplant recipients receiving either lamivudine (LAM) monotherapy or LAM combined with low-dose intramuscular (IM) hepatitis B Immunoglobulin (HBIG) therapy.Methods We performed a retro-spective review of the medical records of patientsthat were transplanted in a single center for HBV-related liver diseases from December 1999 to June 2004.A total of 165 patients received LAM monotherapy (51 patients) or combined prophylaxis (114 patients) post-LT with a mean follow-up of 20.13 months.Results Hepatitis B relapsed in 21 patients of the HBsAg carriers who receivedLAMmonotherapy, with a 1-and 2-year actuarial risk of 27.4% and 39.7%. Recurrence occurred in 16 patients of 114 patients receiving the combined prophylaxis, with a 1-and 2-year recurrence rate of 13.5% and 15.2%_P=0.024. 25 cases (67.6%) with YMDD mutants were detected in all the 37 patients, 14 cases (66.7%) in the monotherapy group and 11cases (68.8%) in the combination group.Conclusions LAM and low-dose intramuscular HBIG treatment demonstrates a better result than LAM monotherapy, as prophylaxis against posttransplant reinfection of the graft, but the safety and efficacy, as a substitution for high-dose intravenous HBIG with LAM needs to be further investigated...