是的简单 nucleos (t) ides 肝以后的移植的 HBV 预防政体: 六年列在后面起来

• 作者: Kang-Xian Luo, Fu-Yuan Zhou, Ding-Li Liu, Xiao-Rong Feng
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: CHRONIC HEPATITIS B HEPATITIS B IMMUNOGLOBULIN Liver TRANSPLANTATION Nucleos(t)ides
• 年，卷（期）: 2010,（12）
• 页码范围: 447-450
• 页数: 4页
• 分类号: R512.62

摘要

A combination of nucleos(t)ides and hepatitis B immunoglobulin (HBIg) has been found to be effective for the prevention of hepatitis B viral (HBV) reinfection after liver transplantation (LT),but its administration is costly,and not always available. We report the case of a male,33-year-old cirrhotic patient who has tested positive for serum HBsAg,and HBeAg,with 9.04 × 107 copies/mL of HBV DNA. He suffered from acute liver failure and was near death before undergoing emergency LT. No HBIg was available at the time,so only lamivudine was used. He routinely received immunosuppression medication. Serum HBV DNA and HBsAg still showed positive post-LT,and the graft re-infected. Hepatitis B flared three months later. Adefovir dipivoxil was added to the treatment,but in the 24th mo of treatment,the patient developed lamivudine resistance and a worsening of the hepatitis occurred shortly thereafter. The treatment combination was then changed to a double dosage of entecavir and the disease was gradually resolved. After 60-mo of post-LT nucleos(t)ide analogue therapy,anti-HBs seroconverted,and the antiviral was stopped. By the end of a 12-mo follow-up,the patient had achieved sustained recovery. In conclusion,the case seems to point to evidence that more potent and less resistant analogues like entecavir might fully replace HBIg as an HBV prophylaxis and treatment regimen.