Karaciğer Nakli Alıcılarında Hepatit B Virus Proflaksisi

Year 2020, Volume: 30 Issue: 1, 1 - 4, 01.03.2020

Gökhan Ertuğrul

Abstract

Amaç: Karaciğer nakli alıcılarında kullanılan immunsüpresif ilaçlar Hepatit B Virus HBV reaktivasyonunu kolaylaştırır. Bu hastalarda, virüs reaktivasyonunu önlemek için verilen proflaktik tedaviler çok önemlidir.Bu çalışmanın amacı karaciğer nakli alıcılarında nüks HBV enfeksiyonlarının proflaksisini değerlendirmektir. Gereç ve Yöntem: Bu çalışma retrospektiftir. Karaciğer nakli alıcılarını Ocak 2016 ile Ocak 2019 tarihleri arasında HBVDNA ve proflaktik tedavi sonuçları ile inceledik. Bulgular: 34 alıcı hastaya proflaktik tedavi için Tenofovir ya daEntacavir verilmişti. Ortalama 27,3 aylık takipte hastalarda nüks tespit edilmedi. Sonuç: Tenofovir ve Entacavir, karaciğer nakli alıcılarında nüks HBV enfeksiyonunun proflaktik tedavisinde başarılı görünmektedir

Keywords

Karaciğer nakli, nüks HBV enfeksiyonu, proflaksi

Prophylaxis for hepatitis B virus in liver transplant recipients

Abstract

Objective: Immunosuppressive drugs predispose the liver transplant recipients to reactivation of Hepatitis B virus. Prophylactic therapies given to this patient are very important for prevention of infections. The aim of this study was to evaluate the prophylaxis recurrence HBV infections in liver transplant recipients.Material and Methods: This study is retrospective. We examined liver transplant recipients Between January 2016 and January 2019 with results of HBV DNA and prophylactic treatment.Results: 34 recipient patients were treated with Tenofovir or Entacavir prophylaxis. There was not recurrence of HBV infections during follow-up of 36 months.Conclusion: Tenofovir or Entacavir appears to be successful prophylactic treatment of recurrence HBV infections in liver transplant recipients

Keywords

Liver transplantation, recurrence HBV infections, prophylaxis

References

• Burra P, Germani G, Adam R, et al. Liver transplantation for HBV-related cirrhosis in Europe: an ELTR study on evo- lution and outcomes. J Hepatol 2013; 58: 287-96.
• Zheng SS, Wu J, Liang TB, et al. Prophylaxis and treatment of hepatitis B virus reinfection following liver transplantati- on. Hepatobiliary Pancreat Dis Int 2002; 1: 327-9.
• Akyildiz M, Karasu Z, Zeytunlu M, et al. Adefovir dipivoxil therapy in liver transplant recipients for recurrence of he- patitis B virus infection despite lamivudine plus hepatitis B immunoglobulin prophylaxis. J Gastroenterol Hepatol 2007; 22: 2130-4.
• Cholongitas E, Papatheodoridis GV. High genetic barrier nucleos(t)ide analogue(s) for prophylaxis from hepatitis B virüs recurrence after liver transplantation: a systematic re- view. Am J Transplant 2013; 13: 353-62.
• Cholongitas E, Vasiliadis T, Antoniadis N, et al. Hepatitis B prophylaxis post liver transplantation with newer nucleo- s(t)ide analogues after hepatitis B immunoglobulin discon- tinuation. Transpl Infect Dis 2012; 14:479-87.
• Samuel D, Muller R, Alexander G, et al. Liver transplanta- tion in European patients with the hepatitis B surface anti- gen. N Engl J Med 1993; 329: 1842-7.
• Shouval D, Samuel D. Hepatitis B immune globulin to prevent hepatitis B virus graft reinfection following liver transplantation: a concise review. Hepatology 2000; 32: 1189-95.
• Laryea MA, Watt KD. Immunoprophylaxis against and pre- vention of recurrent viral hepatitis after liver transplantati- on. Liver Transpl 2012; 18: 514-23.
• Markowitz JS, Martin P, Conrad AJ, et al. Prophylaxis aga- inst hepatitis B recurrence following liver transplantation using combination lamivudine and hepatitis B immune globulin. Hepatology 1998; 28: 585-9.
• Peng CY, Chien RN, Liaw YF. Hepatitis B virus-related de- compensated liver cirrhosis: benefits of antiviral therapy. J Hepatol 2012; 57: 442-50.
• Marcellin P, Gane E, Buti M, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for ch- ronic hepatitis B: a 5-year open-label follow-up study. Lan- cet 2013; 381: 468-75.
• Fung J, Chan SC, Cheung C, et al. Oral nucleoside/nucleo- tide analogs without hepatitis B immune globülin after liver transplantation for hepatitis B. Am J Gastroenterol 2013; 108: 942-8.