Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Management of HBV Infection in Liver Transplantation Patients. | Int. J. Med. Sci. 2005 2 1 41 Review Received Accepted PubliShed Abstract Key words Author biography Corresponding address International Journal of Medical Sciences ISSN 1449-1907 2005 2 1 41-49 2005 Ivyspring International Publisher. All rights reserved Management of HBV Infection in Liver Transplantation Patients John M. Vierling David Geffen School of Medicine at University of California Los Angeles CA USA In the absence of preventative therapy reinfection of allografts with hepatitis B virus HBV after orthotopic liver transplantation OLT resulted in dismal allograft and patient survival. Major advances in the management of HBV-infected recipients of OLT during the past 15 years have steadily reduced the rate of reinfection resulting in improved outcomes. Initially long-term use of hepatitis B immune globulin HBIG as a source of anti-HBs antibodies was effective in preventing or delaying reinfection. Lamivudine monotherapy made it possible to suppress HBV replication prior to OLT markedly decreasing the risk of reinfection. Although lamivudine monotherapy used before and after OLT could prevent reinfection its effectiveness was limited by progressive development of lamivudine-resistant mutant infections. Combination therapy with HBIG and lamivudine after OLT reduced both HBV recurrence and the risk of lamivudine resistance even in patients with active HBV replication. Introduction of adefovir provided a safe alternative oral antiviral able to treat effectively lamivudine-resistant mutants HBV. Available strategies to prevent reinfection have resulted in OLT outcomes for HBV-infected patients comparable to those for patients transplanted for non-HBV indications. In the future combination therapies of HBIG and both nucleoside and or nucleotide agents will undoubtedly be optimized. Development of new drugs to treat HBV will increase opportunities to combine agents to enhance safety efficacy and prevent emergence of .
