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Titolo:
Management of hepatitis B virus infection in liver transplant recipients: prospects and challenges
Autore:
Terrault, N;
Indirizzi:
Univ Calif San Francisco, Div Gastroenterol, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA
Titolo Testata:
CLINICAL TRANSPLANTATION
, volume: 14, anno: 2000, supplemento:, 2
pagine: 39 - 43
SICI:
0902-0063(200008)14:<39:MOHBVI>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNE GLOBULIN PROPHYLAXIS; SURFACE-ANTIGEN; PASSIVE-IMMUNIZATION; IMMUNOGLOBULIN; IMMUNOPROPHYLAXIS; RECURRENCE; HBSAG; LAMIVUDINE; CIRRHOSIS; MUTANTS;
Keywords:
antibody; famciclovir; HBIg; HBSAg; hepatitis B virus; lamivudine; liver; mutation; transplantation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Terrault, N Univ Calif San Francisco, Div Gastroenterol, S357 513 Parnassus Ave, San Francisco, CA 94143 USA Univ Calif San Francisco S357 513 Parnassus Ave San Francisco CA USA 94143
Citazione:
N. Terrault, "Management of hepatitis B virus infection in liver transplant recipients: prospects and challenges", CLIN TRANSP, 14, 2000, pp. 39-43

Abstract

Although survival of liver transplantation for patients with hepatitis B infection is comparable to uninfected transplant recipients, prevention of hepatitis B virus (HBV) reinfection remains an important goal. In this article, several aspects of the hepatitis B reinfection and its management will be examined. Approximately 50% of the treatment failures that occur with hepatitis B immune globulin (HBIg) prophylaxis are due to mutations in the 'a' determinant of the HBV. In patients without mutations, failure of HBIg therapy may relate to the frequency and dose of HBIg, the type and amount of immunosuppression, and the pre-transplant replication status. Antiviral therapy with lamivudine and famciclovir has been used successfully to treat patients who have failed HBIg treatment and as monotherapies for liver transplant recipients. Combining antiviral and immunomodulatory therapies appearsefficacious, at least in the short term. New developments related to immunotherapy predict three potential trends in future use: 1) i.v. formulated HBIg, 2) monoclonal antibodies, or 3) hepatitis B immune plasma. In conclusion, there are an increasing number of therapeutic options for the management of patients undergoing liver transplantation for hepatitis B infection. Continued improvement in patient outcomes requires further understanding of each therapeutic agent and the specific patient characteristics that may influence efficacy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 00:31:07