Hepatitis B immune globulin to prevent hepatitis B recurrence after liver transplant: A single-center experience

Vollständiger Abstract

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BACKGROUND Hepatitis B surface antigen (HBsAg) positive liver transplant (LT) recipients are at an increased risk for hepatitis B virus (HBV) recurrence without prophylaxis with hepatitis B immune globulin (HBIG), nucleos(t)ide analogue, or a combination. AIM To describe the use of HBIG in HBsAg positive LT recipients and explore the association between HBIG duration and HBV recurrence. METHODS We performed a retrospective, single-center cohort study of HBsAg positive LT recipients between January 1, 2016 and July 31, 2023. A descriptive statistical analysis was performed. The primary outcome was HBV virologic recurrence at 12 months post-LT, defined as HBV DNA > 100 IU/mL. RESULTS A total of 14 LT recipients (64% males, median age 59 years) were included. Reasons for LT were cirrhosis with hepatocellular carcinoma (n = 5), other complications of cirrhosis (n = 6), and acute liver failure (n = 3). Ten patients received HBIG after LT, with treatment duration ranging from 5 days to 12 months. All patients had HBV DNA < 100 IU/mL by 2 months post-LT. Of the 14 patients, 12 had HBV DNA < 20 IU/mL at either 6 or 12 months post-LT. None of the patients developed HBsAg positivity post-LT. CONCLUSION In this small, single-center cohort, shorter durations of HBIG (≤ 6 months) were not associated with HBV recurrence. These findings suggest that time-limited HBIG may be feasible in selected HBsAg-positive LT recipients, but should be interpreted with caution and require validation in larger, prospective studies.