Outcomes of Long-Term Administration of Intravenous Hepatitis B Immunoglobulins for the Prevention of Recurrent Hepatitis B After Liver Transplantation

Purpose. The aim of this study was to investigate the safety and efficacy of lifelong therapy with intravenous hepatitis B immunoglobulins (IV HBIg) to prevent recurrence of hepatitis B after orthotopic liver transplantation (OLT). Methods. This was a single-center retrospective study of the long-term outcome of 56 patients who were transplanted for active hepatitis B related liver disease. In addition to IV HBIg, patients received antiviral therapy for at least 1 year. Results. 1-, 5-, and 10-year survival rates were 95%, 82%, and 80%, respectively. None of the patients died due to hepatitis B virus (HBV)-related complications. In 3 patients (5%), a hepatitis B surface antigen (HBsAg) negative status was not reached. All of these patients had a very high viral load at the time of OLT. HBsAg and HBV DNA reappeared in 6 patients (11%): In 1 patient, recurrence occurred 9 months after OLT while still under combination treatment with lamivudine, and 2 patients were temporarily treated abroad with intramuscular HBIg. Only 3 patients suffered from HBV recurrence while under monotherapy with IV HBIg. No serious side effects to IV HBIg were reported during this long-term follow-up. Conclusion. Lifelong administration of IV HBIg is safe, and recurrence of HBV disease occurred only in a minority of the patients during long-term follow-up. Prognosis of HBV-related OLT with this therapy is excellent.