Drug cocktail prevents hepatitis B virus from recurring after liver transplant

Aiming to prevent recurrence of the hepatitis B virus (HBV) in post liver-transplant patients, UCLA researchers retrospectively reviewed survival rates of hepatitis B liver-transplantation patients. Their findings show that a combination of two drug therapies improved patient survival rates when compared to existing drug therapies given alone and that long-term treatment dramatically decreases recurrence of the disease.

The results, published in the May issue of the Annals of Surgery, showed the viral prophylaxis therapy or preventive treatment of hepatitis B immune globulin (HBIg) and lamivudine in combination prevents recurrence of HBV infection and lengthens patient survival rates following liver transplantation.

Researchers studied a total of 3,094 liver transplants performed at UCLA Medical Center from 1984 through April 2001. Of those, 191 transplant operations were performed on 166 patients afflicted with HBV cirrhosis. The patients were divided into four treatment groups: no prophylaxis, lamivudine monotherapy, HBIg monotherapy, or a lamivudine and HBIg combination.

When comparing the combination therapy to the monotherapy or no therapy, the HBV-free survival rates were considerably higher for patients who received the combination of HBIg and lamivudine. The one-year and three-year survival rates for the combination therapy were 92 percent and 81 percent, respectively. Survival rates for lamivudine alone were 72 percent and 62 percent. Survival rates for patients who were given HBIg alone were even lower at 45 percent and 36 percent.

Researchers also considered what effect therapy duration might have in HBV recurrence. With short-term HBIg monotherapy, HBV infection recurred in 60 percent of patients after transplant. With long term HBIg monotherapy, which is defined as greater than six months, 40 percent of the patients suffered HBV recurrence. But patients receiving long-term HBIg and lamivudine therapy had a dramatic redu

Contact: Kirsten Holguin
University of California - Los Angeles

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