Experiences of prevention and treatment of hepatitis B virus reinfection after liver transplantation for severe hepatitis B: report of 121 cases

Objective To explore and discuss the prevention and treatment of hepatitis B virus reinfection after liver transplantation for severe hepatitis B. Methods One hundred and twenty-one cases of severe hepatitis B were given antiviral drugs pre and post transplantation to prevent hepatitis B virus reinfection. Lamivudine+HBIg was administered in 114 cases, lamivudine+adefovir+HBIg in 4 cases and entecavir+HBIg in 3 cases. The serum HBsAg, serum HBeAg, HBV DNA, liver biopsy, immunohistochemistry and clinical symptoms were observed. Results Four of 114 cases given lamivudine+HBIg developed reinfection, in whom serum HBsAg was positive and liver biopsy immunohistochemistry showed HBsAg phenotype. The serum HBV DNA was positive in one of them. The serum HBsAg phenotype of three cases was negative after therapy. Four cases given adefovir and 3 cases given entecavir did not developed reinfection with HBV. Conclusions Lamivudine+HBIg, lamivudine+adefovir+HBIg, entecavir+HBIg and proper use of immunosuppressant can effectively prevent hepatitis B virus reinfection after liver transplantation for severe hepatitis B.