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Journal of Immunology Research
Volume 2014 (2014), Article ID 764234, 9 pages
http://dx.doi.org/10.1155/2014/764234
Clinical Study

Reestablishment of Active Immunity against HBV Graft Reinfection after Liver Transplantation for HBV-Related End Stage Liver Disease

1Department of Hepatobiliary Surgery and Liver Transplantation Program, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
2Institute & Hospital of Hepatobiliary Surgery, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA Medical School, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
3Department of General Surgery, Chengdu First People’s Hospital, Sichuan 610041, China
4Key Laboratory of Transplant Engineering and Immunology of Health Ministry, West China Hospital, Sichuan University, Chengdu, Sichuan 610044, China

Received 20 September 2014; Accepted 18 November 2014; Published 18 December 2014

Academic Editor: Xiao-Feng Yang

Copyright © 2014 Shi-Chun Lu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol. Method. Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer. Results. Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection. Conclusions. Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.