[Current concepts for prophylaxis and treatment of hepatitis B virus reinfection after liver transplantation.] Medizinische Klinik (Munich, Germany : 1983) [Med Klin (Munich)] Journal article | | Title | [Current concepts for prophylaxis and treatment of hepatitis B virus reinfection after liver transplantation.] | | Author(s) | Beckebaum S, Cicinnati VR, Gerken G | | Institution | Klinik für Gastroenterologie und Hepatologie, Universitätsklinikum Essen, Essen, susanne.beckebaum@uni-due.de. | | Source | Med Klin (Munich) 2008 Apr 15; 103(4):190-7. | | Abstract | Pretransplant complete viral suppression and posttransplant combined hepatitis B immunglobulin (HBIG)/nucleos(t)ide analog therapy lead to successful prevention of hepatitis B virus (HBV) reinfection in approximately 95% of HBV patients. Low-dose intramuscular HBIG protocols have yielded cost reduction by > 50%. However, passive immunoprophylaxis is still expensive and requires close monitoring of the liver transplant (LT) patient. HBIG-free therapeutic regimens with new promising nucleos(t)ide analog combinations are currently being investigated for their efficacy and safety as first-line therapy in clinical studies.Third-generation HBV vaccines, including the S, pre-S1, and pre-S2 regions or combination vaccines with immunostimulatory adjuvants, seem to be more immunogenic than the currently available vaccines and may allow long-term discontinuation of HBIG in selected responders. Adoptive transfer of immunity against HBV was successful in some LT patients in clinical studies. Future investigations need to elucidate, if donor-derived immunity is a transient immunologic phenomenon or persistently controls HBV. | | Language | ger | | Pub Type(s) | English Abstract
Journal Article
| | PubMed ID | 18484203 |
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