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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Bibliographic Details
Authors: 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
Format: article
Status:Versión aceptada para publicación
Publication Date:2023
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/217868
Online Access:https://hdl.handle.net/2445/217868
http://hdl.handle.net/2445/217868
Access Level:Open access
Keyword:Hepatitis B
Trasplantament hepàtic
Virus de l'hepatitis delta
Hepatic transplantation
Delta-associated agent
Description
Summary: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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