Abstract：
Recommended post-liver transplant (LT) prophylaxis in patients with hepatitis delta includes a nucleos(t)ide analogue (NA) and anti-hepatitis B immunoglobulin (HBIG) indefinitely. We analysed the use of HBIG in real-life clinical practice and its impact on HBV/HDV recurrence in 174 HDV-related LT patients from 10 Spanish liver transplant centres (1988-2018). Median post-LT follow-up was 7.8 (2.3-15.1) years and patient survival at 5 years was 90%. Most patients (97%) received HBIG in the immediate post-LT, but only 42% were on HBIG at the last control. Among those discontinuing HBIG, the median time on treatment was 18 (7-52) months. Post-LT HBsAg+ was detected in 16 (9%) patients and HBV-DNA in 12 (7%). Despite HBsAg positivity, HDV recurrence was reported only in three patients (1.7%), all of whom were not receiving NA and had discontinued HBIG. Our data suggest that a finite HBIG prophylaxis in HDV-LT is feasible, especially if high-barrier NAs are used.
摘要：
推荐的丁型肝炎患者的肝移植后（LT）预防包括无限期的核苷（酸）类似物（NA）和抗乙型肝炎免疫球蛋白（HBIG）。我们分析了HBIG在现实生活中的临床实践中的使用及其对来自10个西班牙肝移植中心（1988-2018）的174例HDV相关LT患者HBV/HDV复发的影响。术后随访中位数为7.8年（2.3-15.1年），患者5年生存率为90％。大多数患者（97％）在LT后立即接受HBIG，但在最后一次控制时，只有42％的人使用HBIG。在那些停止HBIG的人中，中位治疗时间为18(7-52)个月.在16（9％）患者中检测到LT后HBsAg+，在12（7％）中检测到HBV-DNA。尽管HBsAg阳性，HDV复发仅在3例患者中报告（1.7％），所有患者均未接受NA治疗,且已停用HBIG.我们的数据表明，在HDV-LT中进行有限的HBIG预防是可行的，特别是如果使用高阻隔NA。
