The role of HBIG in real life for patients undergoing liver transplantation due to HDV-related cirrhosis

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 pa...

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Autores: Rodriguez-Tajes, Sergio; Garcia-Eliz, María; Caballero Marcos, Arantxa; Campos Varela, Isabel; Cachero Ros, Alba; Loinaz, Carmelo; Gómez Bravo, Miguel Ángel; Rodríguez Perálvarez, Manuel; Fabrega, Emilio; González Diéguez, María Luisa; Vinaixa, Carmen; Pascasio, Juan Manuel; Fernández Vázquez, Inmaculada; Baliellas, Carmen; Castells, Lluís; Salcedo, Magdalena; Prieto Castillo, Martín; Crespo, Gonzalo; Lens García, Sabela; Forns, Xavier
Tipo de documento: Artículo
Estado:Accepted version
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/217868
Acceso en línea:https://hdl.handle.net/2445/217868
http://hdl.handle.net/2445/217868
Nivel de acceso:Acceso abierto
Palabra clave:Hepatitis B
Trasplantament hepàtic
Virus de l'hepatitis delta
Hepatic transplantation
Delta-associated agent
Sumario: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.

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