[Prevention and treatment of HBV reinfection following liver transplantation].
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To study the prevention and treatment of HBV reinfection after liver transplantation.Total 19 cases of chronic fulminant hepatitis B, the end-stage of liver cirrhosis and liver carcinoma complicated with HBV cirrhosis. Were performed liver transplantation and given anti-viral drugs pre and post transplantation. Famciclovir was administered in 4 cases, lamivudine in 13 cases and lamivudine+HBIG in 2 cases. The serum HBVM and liver biopsy immunohistochemistry were performed.Four cases given famciclovir developed reinfection. Serum HBsAg, HBeAg and HBV DNA were positive in 3 cases. Liver biopsy immunohistochemistry showed HBsAg and HBeAg phenotype. Classical viral hepatitis in 1 case occurred, three cases died. In the lamivudin group 7 cases showed positive for HBsAg, 2 cases positive for HBV DNA, 4 cases HBsAg or HBcAg phenotype. One case showed positive for serum anti-HBc the other negative for HBVM, and liver biopsy immunohistochemistry was negative too.These date suggest that anti-virus prevention and treatment in pre and post liver transplantation with HBV infected correlative disease is necessary, feasible and effective.Keywords:
Famciclovir
HBeAg
HBcAg
Hepatitis B
Liver disease
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To investigate the risk factors and treatment of hepatitis B virus (HBV) reinfection after liver transplantation.Patients with HBV related end-stage liver disease underwent liver transplantation in our center, and received the combination of intramuscular hepatitis B virus immunoglobulin and oral lamivudine as prophylaxis for HBV reinfection. HBV reinfection cases were monitored after the transplantation.HBsAg disappeared and HBsAb was detectable in 128 of total 130 patients. The median follow-up period was 12.2 months after transplantation. Eight patients developed HBV reinfection. The recurrence rate of HBV was 6.3%. The reinfection risks were 14.3% and 4.0% respectively among patients with serum HBeAg positive and negative before transplantation (P < 0.05). Among patients with serum HBsAg positive and negative at the first day after liver transplantation, the reinfection risks were 21.1% and 3.7% respectively (P < 0.05).Combination of intramuscular HBIg and Lamivudine as prophylaxis of HBV reinfection is effective. HBeAg positive before liver transplantation and HBsAg positive at the first day after transplantation are risk factors of HBV reinfection.
HBeAg
Hepatitis B
Liver disease
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Objective To prevent and early diagnose hepatitis B virus(HBV) reinfection and recurrent hepatitis B following liver transplantation.and to discuss the further treatment of recurrent hepatitis B.Methods Patients undergoing liver transplantation received lamivudine to prevent HBV reinfection.Virological and biochemical data,serum HBV-DNA,and immunohistological staining for HBsAg and HBcAg in biopsy liver tissue were tested in due time.Results Of 4 cases diagnosed as having HBV reinfection,two presented hepatitis B recurrence after liver transplantation:One developed to chronic severe hepatitis B after great efforts of treatment and one improved after a series of treatment.Conclusions HBV reinfection or recurrent hepatitis B following liver transplantation occurred mostly about 6 to 12 months after operation.It should be considered hepatitis B recurrence when liver biochemistrical data became poor during this period.The treatment for recurrent hepatitis B after liver transplantation included increasing dosage of lamivudine.application of famciclovir,and other liver protective measures.
Key words:
Liver transplantation; Hepatitis B virus; Recurrence
HBcAg
Hepatitis B
Famciclovir
Hepatitis D virus
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This retrospective study was designed to evaluate the safety and efficacy of long-term lamivudine therapy in Korean patients with chronic hepatitis B virus (HBV) with or without cirrhosis. Study patients were men and women who had received lamivudine 100 mg/day p.o. for 52 wk for treatment of biopsy-proven chronic HBV; 1½9 patients had cirrhosis. Patient eligibility requirements included having a diagnosis of chronic HBV, being positive for HBV by polymerase chain reaction, at least 18 yr of age, and positive for HBsAg, and having abnormally elevated ALT levels. Patients were evaluated for changes in HBV DNA and ALT concentrations, rates at which HBeAg was converted to negative, development of lamivudine resistance, and differences in the drug's effectiveness between patients with and without cirrhosis. Responses of serum HBV DNA and ALT were categorized into three groups according to degree of response to lamivudine treatment: continuous, unstable, and no response. Twenty-nine patients were evaluated in this retrospective analysis. Therapy with lamivudine suppressed serum HBV DNA to undetectable levels in 97% of patients within 12 wk and remained undetectable in 83% of patients after 52 wk. Differences in responses of HBV DNA and ALT to lamivudine therapy in HBeAg-positive and -negative patients and in the development of drug resistance between patients with and without cirrhosis were negligible. Pretreatment HBV DNA and ALT levels had no effect on the efficacy of lamivudine (p = 0.9116). No serious adverse events were reported.
Pharmacotherapy
Hepatitis B
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To study the prevention and treatment of HBV reinfection after liver transplantation.Total 19 cases of chronic fulminant hepatitis B, the end-stage of liver cirrhosis and liver carcinoma complicated with HBV cirrhosis. Were performed liver transplantation and given anti-viral drugs pre and post transplantation. Famciclovir was administered in 4 cases, lamivudine in 13 cases and lamivudine+HBIG in 2 cases. The serum HBVM and liver biopsy immunohistochemistry were performed.Four cases given famciclovir developed reinfection. Serum HBsAg, HBeAg and HBV DNA were positive in 3 cases. Liver biopsy immunohistochemistry showed HBsAg and HBeAg phenotype. Classical viral hepatitis in 1 case occurred, three cases died. In the lamivudin group 7 cases showed positive for HBsAg, 2 cases positive for HBV DNA, 4 cases HBsAg or HBcAg phenotype. One case showed positive for serum anti-HBc the other negative for HBVM, and liver biopsy immunohistochemistry was negative too.These date suggest that anti-virus prevention and treatment in pre and post liver transplantation with HBV infected correlative disease is necessary, feasible and effective.
Famciclovir
HBeAg
HBcAg
Hepatitis B
Liver disease
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Objective To explore and discuss the prevention and treatment of hepatitis B virus reinfection after liver transplantation for severe hepatitis B. Methods One hundred and twenty-one cases of severe hepatitis B were given antiviral drugs pre and post transplantation to prevent hepatitis B virus reinfection. Lamivudine+HBIg was administered in 114 cases, lamivudine+adefovir+HBIg in 4 cases and entecavir+HBIg in 3 cases. The serum HBsAg, serum HBeAg, HBV DNA, liver biopsy, immunohistochemistry and clinical symptoms were observed. Results Four of 114 cases given lamivudine+HBIg developed reinfection, in whom serum HBsAg was positive and liver biopsy immunohistochemistry showed HBsAg phenotype. The serum HBV DNA was positive in one of them. The serum HBsAg phenotype of three cases was negative after therapy. Four cases given adefovir and 3 cases given entecavir did not developed reinfection with HBV. Conclusions Lamivudine+HBIg, lamivudine+adefovir+HBIg, entecavir+HBIg and proper use of immunosuppressant can effectively prevent hepatitis B virus reinfection after liver transplantation for severe hepatitis B.
Entecavir
Adefovir
HBeAg
Hepatitis B
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Immunoperoxidase techniques were used to investigate the localization patterns and distribution of hepatitis B virus (HBV)-associated antigens in hepatitis B surface antigen (HBsAg)-positive patients with liver cirrhosis. The membranous type of HBsAg was rarely seen in liver cirrhosis unless there was concomitant evidence of chronic active hepatitis. HBsAg was stained mainly throughout the hepatic cytoplasm or its periphery in liver cirrhosis regardless of the presence of the hepatitis B e antigen (HBeAg) or hepatitis B e antibody (HBeAb) in the serum. In all cases of liver cirrhosis with hepatocellular carcinoma, the inclusion body type of HBsAg was detected in hepatocytes. Simultaneous staining of HBsAg and hepatitis B core antigen (HBcAg) in biopsy tissues of liver cirrhosis revealed that the HBcAg was mainly stained in the nuclei of hepatocytes, and that almost all of the HBcAg-positive hepatocytes contained either cytoplasmic or festoon-like immunoreaction patterns of HBsAg. HBcAg-positive hepatocytes were distributed spottedly, diffusely or in groups in pseudolobules, and clusters of HBcAg-positive hepatocytes were detected in the non-tumor areas adjacent to hepatomas, where liver cell dysplasia was also observed.
HBcAg
HBeAg
Hepatitis B
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This retrospective study was designed to evaluate the safety and efficacy of long-term lamivudine therapy in Korean patients with chronic hepatitis B virus (HBV) with or without cirrhosis. Study patients were men and women who had received lamivudine 100 mg/day p.o. for 52 wk for treatment of biopsy-proven chronic HBV; 11/29 patients had cirrhosis. Patient eligibility requirements included having a diagnosis of chronic HBV, being positive for HBV by polymerase chain reaction, at least 18 yr of age, and positive for HBsAg, and having abnormally elevated ALT levels. Patients were evaluated for changes in HBV DNA and ALT concentrations, rates at which HBeAg was converted to negative, development of lamivudine resistance, and differences in the drug's effectiveness between patients with and without cirrhosis. Responses of serum HBV DNA and ALT were categorized into three groups according to degree of response to lamivudine treatment: continuous, unstable, and no response. Twenty-nine patients were evaluated in this retrospective analysis. Therapy with lamivudine suppressed serum HBV DNA to undetectable levels in 97% of patients within 12 wk and remained undetectable in 83% of patients after 52 wk. Differences in responses of HBV DNA and ALT to lamivudine therapy in HBeAg-positive and -negative patients and in the development of drug resistance between patients with and without cirrhosis were negligible. Pretreatment HBV DNA and ALT levels had no effect on the efficacy of lamivudine (p = 0.9116). No serious adverse events were reported.
HBeAg
Hepatitis B
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HBeAg
Seroconversion
Liver disease
Hepatitis B
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HBcAg
Hepatitis B
HBeAg
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HBcAg
Famciclovir
Hepatitis B
Hepatitis D virus
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Citations (7)