Hepatitis B virus and liver transplantation: Concepts in antiviral prophylaxis

Liver transplantation remains problematic in patients with end-stage liver disease secondary to chronic hepatitis B virus (HBV) infection, Recurrent hepatitis is almost universal in those patients who are HBV DNA-positive prior to transplantation. Prophylactic hepatitis B immune globulin can be given to reduce the rate of hepatitis B recurrence in patients who are HBV DNA-negative prior to transplantation. More recently novel antiviral drugs such as lamivudine or famciclovir have been used specifically to inhibit hepatitis B viral replication, However, the development of drug-resistant viral mutants have been observed, Further studies are needed to investigate these drugs more extensively, particularly to assess whether combination therapy map be a more effective means of controlling viral recurrence in patients transplanted for chronic HBV infection.