核苷类似物联合乙肝免疫球蛋白预防肝移植后乙肝病毒再感染的远期效果

Long-term effects of nucleoside analogues combined with hepatitis B immunoglobulin in prophylaxis of HBV reinfection for liver transplant recipients

目的评价核苷类似物联合乙肝免疫球蛋白(hepatitis B immunoglobulin,HBIG)对乙肝相关性肝病肝移植后乙肝病毒(hepatitis B virus,HBV)再感染的远期预防效果。方法对在武警总医院长期随访的乙肝相关性肝病肝移植受者的抗乙肝用药情况和血清HBV标志物的检测结果进行回顾性分析。结果截止到2010-02-28,在该院随访超过6个月且坚持联合抗乙肝用药的肝移植受者共计1006例,随访时间6～109个月(中位数60.5个月),术后1、3、5、7年HBV再感染的累积发生率分别为1.3%、2.5%、3.4%和4.2%(P<0.05)。结论联合使用核苷类似物和 HBIG在乙肝相关性肝病肝移植后HBV再感染的预防方面能获得良好的远期效果,单位时间段内HBV再感染发生率随术后时间延长而逐渐降低。

Objective To evaluate the long - term effects of nucleoside analogues combined with hepatitis B immunoglobulin （HBIG） in prophylaxis of HBV reinfection for liver transplant recipients. Methods The anti - HBV regimen and the serum HBV marker were retrospectively studied in the liver transplant recipients for HBV - related liver disease, followed up over six months in this hospital. Results Totally 1006 recipients were enrolled in this study who persisted in the combinant prophylaxis scheme and were followed up for 6 to 109 months （median 60.5 months） by February 2010. The 1 - year, 3 - year,5 - year and 7 - year aecumulative HBV reinfection rates were 1.3% ,2.5% ,3.4% ,and 4.2% respectively （P 〈 0.05）. Conclusions Nucleoside analogues combined with HBIG can bring liver transplant recipients excellent long - term effect in preventing the HBV reinfection. The HBV - reinfection rate decreases gradually in different postoperative periods.