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【文摘发布】肝移植后低剂量HBIG+LAM预防乙肝复发
Author: Gane EJ, Angus PW, Strasser S, Crawford DH, Ring J, Jeffrey GP, McCaughan GW
Gastroenterology. Gastroenterology. 2007 Mar;132(3):931-7.
IF:12.386(2005)
BACKGROUND AND AIMS: High-dose intravenous hepatitis B immunoglobulin (HBIG) may prevent recurrent hepatitis B virus (HBV) infection, but the cost has limited its widespread use in countries with endemic HBV infection. We report on long-term safety and efficacy of an alternative strategy of very low doses (400-800 IU/month) of intramuscular (IM) HBIG plus lamivudine. METHODS: Australian and New Zealand patients who received low-dose HBIG plus lamivudine following liver transplantation for HBV-related end-stage liver disease were studied. Prior to transplantation, patients with detectable serum HBV DNA received lamivudine 100 mg daily. Posttransplantation, all patients received lamivudine 100 mg daily plus IM HBIG 400 or 800 IU daily for 1 week then monthly thereafter. Serum HBV DNA levels were measured prior to lamivudine, at transplantation, and at 12 months posttransplantation. Serum titers of antibody to HBV surface antigen were measured at 1, 3, and 12 months posttransplantation. RESULTS: Between February 1996 and October 2004, 147 patients received low-dose HBIG plus lamivudine. Thirty-one percent were hepatitis B e antigen positive, and 85% were HBV DNA+ prior to transplantation. The median duration of pretransplantation lamivudine was 92 days (range, 1-1775). Median follow-up posttransplantation was 1860 days. Kaplan-Meier patient survival was 92% at 1 year and 88% at 5 years. The actuarial risk of HBV recurrence was 1% at 1 year and 4% at 5 years. Baseline HBV DNA titer was associated with HBV recurrence. CONCLUSION: Low-dose IM HBIG plus lamivudine provides safe and effective long-term prophylaxis against recurrent HBV at <10% the cost of the high-dose regimen. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title:Lamivudine plus low-dose hepatitis B immunoglobulin to prevent recurrent hepatitis B following liver transplantation.
题目：肝移植后低剂量HBIG+LAM预防乙肝复发
Author: Gane EJ, Angus PW, Strasser S, Crawford DH, Ring J, Jeffrey GP, McCaughan GW
作者：Gane EJ, Angus PW, Strasser S, Crawford DH, Ring J, Jeffrey GP, McCaughan GW
Gastroenterology. 2007 Mar;132(3):931-7.
胃肠病学.2007 Mar;132(3):931-7.
IF:12.386(2005)
影响因子：12.386(2005)
BACKGROUND AND AIMS: High-dose intravenous hepatitis B immunoglobulin (HBIG) may prevent recurrent hepatitis B virus (HBV) infection, but the cost has limited its widespread use in countries with endemic HBV infection. We report on long-term safety and efficacy of an alternative strategy of very low doses (400-800 IU/month) of intramuscular (IM) HBIG plus lamivudine.
背景与目的：静脉内给予高剂量的乙肝球蛋白(HBIG)可以防止乙型肝炎病毒(HBV)感染，但是由于费用问题限制了其在乙肝病毒流行国家的应用。在此我们报道了一种具有长期安全性和有效性的替代治疗策略，即肌注剂量很低(400-800 IU/月)的HBIG联合应用拉米夫定。
METHODS: Australian and New Zealand patients who received low-dose HBIG plus lamivudine following liver transplantation for HBV-related end-stage liver disease were studied. Prior to transplantation, patients with detectable serum HBV DNA received lamivudine 100 mg daily. Posttransplantation, all patients received lamivudine 100 mg daily plus IM HBIG 400 or 800 IU daily for 1 week then monthly thereafter. Serum HBV DNA levels were measured prior to lamivudine, at transplantation, and at 12 months posttransplantation. Serum titers of antibody to HBV surface antigen were measured at 1, 3, and 12 months posttransplantation.
方法：对澳大利亚和新西兰与HBV有关的晚期肝病经肝移植后接受低剂量HBIG联合拉米夫定的患者进行了研究。移植前，血清可检出HBV DNA的患者进行每日100mg拉米夫定的治疗。移植后，所用患者均接受每日100mg拉米夫定另加每日肌注HBIG400或800IU为期一周的治疗，随后该治疗每月进行一次。应用拉米夫定以前、移植时及移植后12个月后分别检测血清HBV DNA水平。移植后1个月、3个月和12个月分别检测血清中HBV表面抗体的滴度。
RESULTS: Between February 1996 and October 2004, 147 patients received low-dose HBIG plus lamivudine. Thirty-one percent were hepatitis B e antigen positive, and 85% were HBV DNA+ prior to transplantation. The median duration of pretransplantation lamivudine was 92 days (range, 1-1775). Median follow-up posttransplantation was 1860 days. Kaplan-Meier patient survival was 92% at 1 year and 88% at 5 years. The actuarial risk of HBV recurrence was 1% at 1 year and 4% at 5 years. Baseline HBV DNA titer was associated with HBV recurrence.
结果：在1996年2月到2004年10月间，共有147名或者接受了低剂量HBIG合用拉米夫定疗法。移植前有31％的患者乙肝e抗原阳性，85％为HBV DNA+。移植前拉米夫定的中位持续时间为92天(范围，1-1175)。移植后中位随访期为1860天。Kaplan-meier分析结果显示患者一年和五年存活期分别为92％和88％。精确计算法得出的HBV复发风险第一年为1％，第五年为4％。HBV DNA滴度基线值与HBV的复发有关。
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作者:admin@医学,生命科学 2011-04-06 17:11
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