Review of the pharmacological management of hepatitis B viral infection before and after liver transplantation.

Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE

Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-

Liver Transplantation*/adverse effects; Antiviral Agents/*therapeutic use ; Carcinoma, Hepatocellular/*surgery ; Hepatitis B/*drug therapy ; Liver Cirrhosis/*surgery ; Liver Neoplasms/*surgery; Antiviral Agents/adverse effects ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/virology ; Hepatitis B/complications ; Hepatitis B/diagnosis ; Humans ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/virology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/virology ; Risk Factors ; Secondary Prevention ; Treatment Outcome ; Virus Activation/drug effects

The progress in treatment against hepatitis B virus (HBV) with the development of effective and well tolerated nucleotide analogues (NAs) has improved the outcome of patients with HBV decompensated cirrhosis and has prevented post-transplant HBV recurrence. This review summarizes updated issues related to the management of patients with HBV infection before and after liver transplantation (LT). A literature search using the PubMed/Medline databases and consensus documents was performed. Pre-transplant therapy has been initially based on lamivudine, but entecavir and tenofovir represent the currently recommended first-line NAs for the treatment of patients with HBV decompensated cirrhosis. After LT, the combination of HBV immunoglobulin (HBIG) and NA is considered as the standard of care for prophylaxis against HBV recurrence. The combination of HBIG and lamivudine is related to higher rates of HBV recurrence, compared to the HBIG and entecavir or tenofovir combination. In HBIG-free prophylactic regimens, entecavir and tenofovir should be the first-line options. The choice of treatment for HBV recurrence depends on prior prophylactic therapy, but entecavir and tenofovir seem to be the most attractive options. Finally, liver grafts from hepatitis B core antibody (anti-HBc) positive donors can be safely used in hepatitis B surface antigen negative, preferentially anti-HBc/anti-hepatitis B surface antibody positive recipients.

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Keywords: Adefovir; Antivirals; Entecavir; Hepatitis B virus; Hepatitis B virus immunoglobulin; Lamivudine; Liver transplantation; Resistance; Telbivudine; Tenofovir

0 (Antiviral Agents)

Date Created: 20140111 Date Completed: 20140703 Latest Revision: 20220331

20231215

PMC3882393

10.3748/wjg.v19.i48.9189

24409047