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Titolo:
Combination low-dose hepatitis B immune globulin and lamivudine therapy provides effective prophylaxis against posttransplantation hepatitis B
Autore:
Angus, PW; McCaughan, GW; Gane, EJ; Crawford, DHG; Harley, H;
Indirizzi:
Austin Hosp, Victorian Liver Transplant Unit, Melbourne, Vic 3084, Australia Austin Hosp Melbourne Vic Australia 3084 , Melbourne, Vic 3084, Australia Australian Natl Liver Transplant Unit, Sydney, NSW, Australia Australian Natl Liver Transplant Unit Sydney NSW Australia SW, Australia Queensland Liver Transplantat Serv, Brisbane, Qld, Australia Queensland Liver Transplantat Serv Brisbane Qld Australia Qld, Australia S Australia Liver Transplant Unit, Adelaide, SA, Australia S Australia Liver Transplant Unit Adelaide SA Australia e, SA, Australia New Zealand Liver Transplantat Serv, Auckland, New Zealand New Zealand Liver Transplantat Serv Auckland New Zealand d, New Zealand
Titolo Testata:
LIVER TRANSPLANTATION
fascicolo: 4, volume: 6, anno: 2000,
pagine: 429 - 433
SICI:
1527-6465(200007)6:4<429:CLHBIG>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
ORTHOTOPIC LIVER-TRANSPLANTATION; PASSIVE-IMMUNIZATION; REINFECTION; RECURRENCE; CIRRHOSIS; RECIPIENTS; PREVENTION; INFECTION; DISEASE; ANTIGEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Angus, PW Austin Hosp, Victorian Liver Transplant Unit, Melbourne, Vic 3084, Australia Austin Hosp Melbourne Vic Australia 3084 e, Vic 3084, Australia
Citazione:
P.W. Angus et al., "Combination low-dose hepatitis B immune globulin and lamivudine therapy provides effective prophylaxis against posttransplantation hepatitis B", LIVER TRANS, 6(4), 2000, pp. 429-433

Abstract

Although antiviral prophylaxis with lamivudine monotherapy appears to reduce post-liver transplantation recurrence of hepatitis B virus (HBV) infection, breakthrough infections occur in at least 20% of the patients because of the development of drug resistance. Combined lamivudine and intravenous hepatitis B immune globulin (HBIG) therapy (10,000-IU doses) may reduce thisrisk, but its use is limited by cost (similar to US $45,000/yr) and availability, We report the experience at liver transplant centers in Australia and New Zealand in which lamivudine has been used in combination with much lower doses of HBIG than used in conventional HBIG prophylaxis, Lamivudine, 100 mg/d, was administered to hepatitis B surface antigen (HBsAg)-positive candidates on listing for transplantation and was continued posttransplantation. HBIG, 400 or 800 IU, was administered intramuscularly (IM) daily for 1 week from transplantation and monthly thereafter. Thirty-seven HBsAg-positive patients underwent transplantation using this protocol. Thirty-six of these patients were HBV DNA positive by polymerase chain reaction (PCR) or hybridization assay. Thirty-four patients had chronic HBV, 2 patients had hepatitis B and C, and 1 patient had hepatitis B, C, and D, Five patients died within 1 month of transplantation and are not included in the analysis. Mean follow-up in the remaining 32 patients was 18.4 months (range, 5 to 45months). Treatment was well tolerated, with no significant adverse events. Thirty-one of 32 patients were HBsAg negative, and all 32 patients were HBV DNA negative by PCR at latest follow-up, The cost of treatment was US $967 for lamivudine and between $2,290 and $4,480/yr for IM HBIG, Lamivudine and low-dose HBIG treatment prevents posttransplantation recurrence of hepatitis B and is likely to be more cost-effective than high-dose HBIG regimens.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 08:40:46