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Liver Int ; 44(2): 279-285, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38100141

RESUMO

Recommended post-liver transplant (LT) prophylaxis in patients with hepatitis delta includes a nucleos(t)ide analogue (NA) and anti-hepatitis B immunoglobulin (HBIG) indefinitely. We analysed the use of HBIG in real-life clinical practice and its impact on HBV/HDV recurrence in 174 HDV-related LT patients from 10 Spanish liver transplant centres (1988-2018). Median post-LT follow-up was 7.8 (2.3-15.1) years and patient survival at 5 years was 90%. Most patients (97%) received HBIG in the immediate post-LT, but only 42% were on HBIG at the last control. Among those discontinuing HBIG, the median time on treatment was 18 (7-52) months. Post-LT HBsAg+ was detected in 16 (9%) patients and HBV-DNA in 12 (7%). Despite HBsAg positivity, HDV recurrence was reported only in three patients (1.7%), all of whom were not receiving NA and had discontinued HBIG. Our data suggest that a finite HBIG prophylaxis in HDV-LT is feasible, especially if high-barrier NAs are used.


Assuntos
Transplante de Fígado , Humanos , Antivirais/uso terapêutico , Antígenos de Superfície da Hepatite B , Resultado do Tratamento , Cirrose Hepática/complicações , Cirrose Hepática/cirurgia , Cirrose Hepática/tratamento farmacológico , Imunoglobulinas/uso terapêutico , Recidiva , Vírus da Hepatite B/genética
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