Current prophylactic strategies against hepatitis B virus recurrence after liver transplantation

Table 1 ADV monotherapy vs ADV/LAM combination therapy in patients with lamivudine-resistant chronic hepatitis B

Ref.	Patients (n)		Undetectable HBV DNA		Follow up	P	Normalization of ALT		Follow up	P	ADV resistance		Follow-up	P
	A	AL	A (%)	AL (%)			A (%)	AL (%)			A (%)	AL (%)
[36]	14	28	79	89	At month 36	0.26	73	91	At month 24	0.69	21	0	At month 36	0.020
[37]	23	36	82	89	At month 24	> 0.50	53	79	At month 24	> 0.50	22	0	At month 24	0.001
[38]	28	28	64	40	At month 24	0.38	80	74	At month 12	0.72	18	7	At month 24	0.940
[39]	34	36	82	97	At month 12	> 0.50	79	96	At month 12	> 0.50	18	3	At month 12	> 0.500

A: ADV monotherapy; AL: ADV/LAM combination therapy.

Table 2 Prevention of HBV recurrence after LT with LAM and low-dose IM HBIG

Authors	Patients (n)	DNA+ prior to LT (%)	Pretransplant LAM therapy (%)	Duration of pretransplant LAM therapy (mean mo)	DNA+ at LT (%)	Prophylactic protocol after LT	Follow-up (mean mo)	Recurrence(%)
Jiao et al[90]	79	47	28	0.5	0	LAM + HBIG IM1	29	2.5
Gane et al[91]	147	85	NA	3	< 50	LAM + HBIG IM2	61	4
Zheng et al[77]	114	NA	13	5	31	LAM + HBIG IM3	16	14
Karademir et al[92]	35	51	40	6	14	LAM + HBIG IM4	16	5.7
Angus et al[93]	32	97	100	3.2	NA	LAM + HBIG IM5	18.4	3.1

NA: Not available.

¹2000 IU (IM) at LT, 800 IU (IM) daily for 6 d, weekly for 3 wk, then aim for anti-HBs > 100 IU/L;

²800 IU (IM) at LT and daily for 6 d, then 800 IU (IM) monthly;

³2000 IU (IM) at LT, 800 IU (IM) daily for 6 d, weekly for 3 mo, and then monthly;

⁴4000 IU (IM) at LT, 2000 IU (IM) daily until anti-HBs > 200 IU/L, then aim for > 100 IU/L;

⁵800 IU (IM) at LT and daily for 1 wk, then 800 IU (IM) monthly.

Table 3 Conversion from IV to IM HBIG for prevention of HBV recurrence after LT

Authors	Patients (n)	DNA+ prior to LT (%)	Pretransplant LAM therapy (%)	Duration of pretransplant LAM therapy (mean mo)	DNA+ at LT (%)	Prophylactic protocol after LT	Follow-up (mean mo)	Recurrence (%)
Ferretti et al[94]	23	48	48	NA	13	LAM + HBIG1	20	3.6
Han et al[95]	59	NA	59	7.7	8	LAM + HBIG2	35	03, 24
Faust et al[96]	6	NA	0	0	NA	LAM + HBIG5	43	0

¹80 000 IU (IV) in the first wk, then 1200 IU (IM) to aim for anti-HBs > 100 IU/L;

²IV for a median of 67 wk (LT before August 1998), then IM thereafter; 10 000 IU (IV) at LT, then 10 000 IU (IV) daily for 6 d (LT after August 1998), then IM thereafter;

³The HBV recurrence of patients with LT before August 1998;

⁴The HBV recurrence of patients with LT after August 1998;

⁵10 000 IU (IV) at LT, then 2000 IU (IV) for a median of 7 mo, then IM thereafter.