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 20 January 2018

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News

De novo HBV infection in liver transplantation with hepatitis B core antibody positive donors

Lamivudine for patients receiving anti-HBc positive liver grafts is a simple, inexpensive and effective prophylactic regimen for prevention of de novo HBV infection, find researchers in the December issue of Clinical Transplantation.

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Exclusion of liver grafts from hepatitis B core antibody (anti-HBc) positive donors to prevent de novo hepatitis B virus (HBV) infection after liver transplantation is not feasible in some areas.

In countries like Taiwan, approximately 80% of adults are anti-HBc positive.

No patients given lamivudine developed de novo HBV infection during follow up.
Clinical Transplantation

The efficacy of lamivudine monotherapy to prevent de novo HBV infection after living donor liver transplantation, using grafts from anti-HBc positive donors, remains to be clarified.

In this study, researchers from Kaohsiung, Taiwan, assessed 42 patients who received living donor liver transplantation, between 1994 and 2000; 57% of the donors were anti-HBc positive.

The research team administered pre-transplant HBV vaccination to all recipients irrespective of anti-HBc status at monthly intervals for 3 months.

Prior to December 1997, recipients received liver grafts from anti-HBc positive donors without prophylaxis (n = 8).

However, since January 1998, prophylaxis with lamivudine monotherapy was given to recipients of liver grafts from anti-HBc positive donors (n = 16).

The research team found that de novo HBV infection occurred in 38% of recipients who did not receive prophylaxis.

However, none of the 16 patients given lamivudine developed de novo HBV infection after a mean follow-up of 25 months.

Furthermore, the team found that lamivudine was well tolerated, and no side effects were noted.

Dr Yaw-Sen Chen's team concluded, "These results suggest that lamivudine monotherapy for recipients receiving anti-HBc positive liver grafts is a simple, relatively inexpensive and effective prophylactic regimen for prevention of de novo HBV infection".

"The additive protection provided by vaccine-induced or natural immunity is uncertain".

Clin Transplant 2002; 16(6): 405-9
21 November 2002

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