Pretransplantation interferon treatment and recurrence of hepatitis B virus infection after liver transplantation for hepatitis B–related end-stage liver disease

✍ Scribed by Patrick Marcellin; Didier Samuel; Jorge Areias; Marie-Anne Loriot; Jean-Louis Arulnaden; Michèle Gigou; Marie-FrançOise David; Alain Bismuth; Michel Reynes; Christian Bréchot; Jean-Pierre Benhamou; Henri Bismuth

• Publisher: John Wiley and Sons
• Year: 1994
• Tongue: English
• Weight: 603 KB
• Volume: 19
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840190103

✦ Synopsis

Orthotopic liver transplantation in patients with hepatitis B-related cirrhosis is commonly complicated by reinfection with the hepatitis B virus, with rapidly progressive liver disease and poor survival rate. We assessed the efficacy of prior therapy with recombinant interferon-a on the prevention of posttransplantation hepatitis B virus reinfection. Twenty-two patients with hepatitis B-related cirrhosis waiting for liver transplantation received 3 MU (decreased to 1.5 MU in cases of intolerance) of recombinant interferon-a until transplantation. The rates of posttransplantation hepatitis B virus reinfection and survival in this group were compared with those in a group of 26 patients previously given transplants for the same disease but not given interferon therapy. The same protocol of HBs antibody passive immunoprophylaxis was applied after transplantation in both groups. Recombinant interferon-a was administered for 14 f 7 wk. The treatment had an antiviral effect, with disappearance of serum hepatitis B virus DNA in seven of the eight patients initially positive for hepatitis B virus DNA and disappearance of HBeAg in two of the three patients initially positive for HBeAg. Serum hepatitis B v i m DNA remained detectable with polymerase chain reaction at transplantation in 56% of the interferontreated patients. After transplantation, hepatitis B virus reinfection was more frequent in polymerase chain reaction-positive than in polymerase chain reaction-negative patients (78% vs. 17%, p < 0.05). One patient's condition deteriorated during interferon treatment; this patient was not given a transplant. T w o patients (in whom hepatitis B virus DNA disappeared from serum) improved so markedly during treatment that they were not given transplants. The rates of posttransplant hepatitis B virus reinfection (44% and