Entecavir, tenofovir prevent HBV recurrence in liver transplant patients

Monoprophylaxis with entecavir (ETV) or tenofovir (TDF) following a 6-month combination therapy regimen of hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogues can prevent recurrence of hepatitis B virus (HBV) infection, a recent study has shown.

Researchers followed 77 liver transplant patients, of whom 69 were infected with HBV (group A; median age 53; 80 percent male), while eight were co-infected with HBV and HDV (group B; median age 45 years; 50 percent male). Patients had been receiving HBIg for at least 6 months. After discontinuation, 54 percent were given TDF while 46 percent received ETV.

The median follow-up time after withdrawal from HBIg was 69 and 61 months for groups A and B, respectively. A total of 70 patients showed a progressive drop in serum HB antibodies titres, which reached levels <10 mIU/mL after a median of 4 months. Only seven patients in group A and one in group B had significant antibody levels throughout the study duration.

There were no reported cases of HBV reinfection. Recurrence of HBV antigens were observed in 9 percent (n=6) of group A; no such case was reported for group B.

Overall recurrence was weak, with the median time from discontinuation of HBIg being 18 months. At the time of recurrence, median serum titres for the antibodies and antigens were 0.25 mIU/mL and 0.06 IU/mL, respectively. Only one patient showed significant recurrence titres (35.2 mIU/mL).