Anti-virus prophylaxis withdrawal may be feasible in liver transplant recipients whose serum HBeAg and HBV DNA are negative
Anti-virus prophylaxis withdrawal may be feasible in liver transplant recipients whose serum HBeAg and HBV DNA are negative
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对于血清 HBeAg 和 HBV DNA 阴性的肝移植受者来说，停止抗病毒预防治疗可能是可行的
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Lei Geng
中科院分区：
文献类型：
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作者：
Lei Geng
抗病毒预防性治疗可能不是预防B型肝炎病毒（HBV）相关肝移植（LT）后HBV复发所必需的。然而，在LT后完全停止B型肝炎免疫球蛋白（HBIG）和核苷（酸）类似物（NUC）的研究很少。本研究的目的是评估血清B e抗原（HBeAg）和HBV DNA阴性的肝移植受者停用抗病毒预防性药物的安全性。我们分析了2006年至2012年190例因HBV相关肝病接受LT的患者，发现10例患者因依从性差而完全停止HBIG和NUC。所有患者均行肝活检，每月复查血清HBV标志物、HBV DNA及肝功能。在10例患者中，9例在停用HBIG和NUC后平均随访51.6个月（范围20-73）后未显示HBV复发迹象。从LT到停用抗病毒药物的平均时间为23.8（13-42）个月; 1例患者在停用抗病毒药物后显示B型肝炎表面抗原阳性和可检测到HBV DNA，该患者成功地接受了恩替卡韦治疗。我们的数据表明，对于LT时血清HBeAg和HBV DNA均为阴性的患者，完全停止抗病毒预防是安全可行的。
Anti-virus prophylactic therapy may be not necessary for the prevention of hepatitis B virus (HBV) recurrence after HBV-related liver transplantation (LT). However, studies on completely stopping the hepatitis B immune globulin (HBIG) and nucleos(t)ide analogs (NUC) after LT are few. The aim of the current study was to evaluate the safety of anti-virus prophylaxis withdrawal in liver recipients whose serum hepatitis B e antigen (HBeAg) and HBV DNA are negative. We analyzed 190 patients undergone LT for HBV-related liver disease from 2006 to 2012 and found that 10 patients completely stopped the HBIG and NUC due to poor compliance. These patients were liver biopsied and checked monthly with serum HBV markers, HBV DNA and liver function. Among the 10 patients, 9 did not show the signs of HBV recurrence after a mean follow-up of 51.6 months (range 20-73) after withdrawal of the HBIG and NUC. The average time from LT to the withdrawal of the anti-virus drug was 23.8 (13-42) months; one patient showed hepatitis B surface antigen-positive and detectable HBV DNA after stopping anti-virus drugs and this patient was successfully treated with entecavir. Our data suggested that complete withdrawal of anti-virus prophylaxis was safe and feasible for patients whose serum HBeAg and HBV DNA were negative at the time of LT.