Murat ZEYTUNLU, Sezgin VATANSEVER, Murat KILIÇ, Rasim FARAJOV, Hüseyin Cahit YILMAZ

The efficiency of low-dose hepatitis B immunoglobulin plus nucleos(t)ide analogs in preventing posttransplant hepatitis B virus recurrence

Background/aim: In this study, the efficiency of using low-dose hepatitis B immunoglobulin (HBIG) plus antiviral treatment accordingto individual needs has been evaluated in posttransplant hepatitis B virus (HBV) patients.Materials and methods: We retrospectively evaluated 179 patients who were admitted between 2009 and 2014. Five thousand IUintravenous HBIG was given in the anhepatic phase, and 400 IU/day intramuscular (IM) HBIG was given in the posttransplant period.After HBsAg seroconversion, 400 IU IM HBIG was continued as prophylaxis every two weeks.Results: The average follow-up period was 26 (2–65) months. Seventy patients had hepatocellular carcinoma (HCC). The HBVrecurrence was 4.5% in the first year, and 5.8% in the third year. The HBsAg became negative in 11 (2–63) days, and anti-HBs becamepositive in 9 (1–31) days. HBsAg positivity occurred in 6 patients during the follow-up period. Five of these patients were those whounderwent transplantation due to HCC. In 5 of the HCC patients, in whom HBsAg became positive, tumor recurrence was observedafter 0.3–9.9 months. HBsAg positivity was more frequently detected in patients with HCC (P = 0.009).Conclusion: The HBV recurrence should be evaluated as a predictor of the HCC recurrence in patients who were transplanted due toHCC.

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