Active vaccination to prevent de novo hepatitis B virus infection in liver transplantation

Chih Che Lin, Chee Chien Yong, Chao Long Chen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

The shortage of organ donors mandates the use of liver allograft from anti-HBc(+) donors, especially in areas highly endemic for hepatitis B virus (HBV) infection. The incidence of de novo hepatitis B infection (DNH) is over 30%-70% among recipients of hepatitis B core antibody (HBcAb) (+) grafts without any prophylaxis after liver transplantation (LT). Systematic reviews showed that prophylactic therapy [lamivudine and/or hepatitits B immunoglobulin (HBIG)] dramatically reduces the probability of DNH. However, there are limited studies regarding the effects of active immunization to prevent DNH, and the role of active vaccination is not welldefined. This review focuses on the feasibility and efficacy of pre-and post-LT HBV vaccination to prevent DNH in HBsAg(-) recipient using HBcAb(+) grafts. The presence of HBsAb in combination with lamivudine or HBIG results in lower incidence of DNH and may reduce the requirement of HBIG. There was a trend towards decreasing incidence of DNH with higher titers of HBsAb. High titers of HBsAb (> 1000 IU/L) achieved after repeated vaccination could eliminate the necessity for additional antiviral prophylaxis in pediatric recipients. In summary, active vaccination with adequate HBsAb titer is a feasible, cost-effective strategy to prevent DNH in recipients of HBcAb(+) grafts. HBV vaccination is advised for candidates on waiting list and for recipients after withdrawal of steroids and onset of low dose immunosuppression after transplantation.

Original languageEnglish
Pages (from-to)11112-11117
Number of pages6
JournalWorld Journal of Gastroenterology
Volume21
Issue number39
DOIs
StatePublished - 21 10 2015

Bibliographical note

Publisher Copyright:
© 2015 Baishideng Publishing Group Inc. All rights reserved.

Keywords

  • Core antibody positive donor
  • De novo hepatitis B
  • Liver transplantation
  • Vaccination

Fingerprint

Dive into the research topics of 'Active vaccination to prevent de novo hepatitis B virus infection in liver transplantation'. Together they form a unique fingerprint.

Cite this