Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome

Table 3 Proposed individualized protocols for prophylaxis of hepatitis B virus recurrence post- liver transplantation, based on risk of recurrence

HBV recurrence risk	First 6 mo post-LT	Withdrawal of HBIG
High-risk:
Resistant mutations pre-LT	HBIG-Light	Combination of NAs
HCC at transplant	Plus	(ETV + TFV)
HDV/HBV co-infection	Monotherapy with NA (ETV or TFV)
HIV/HBV co-infection
Non-adherence
Moderate-risk:
HbcAb + donors into HbsAb-recipients	HBIG-Light	Monotherapy with NA
Early post-LT renal dysfunction requiring	Plus	(ETV or TFV)
Indentation NA dose adjustment	Monotherapy with NA (ETV or TFV)
Low risk:
Undetectable HBV DNA at transplant	HBIG-free	Monotherapy with NA
HbcAb + donors into HbsAb + recipients	Monotherapy with NA (ETV or TFV)	(ETV or TFV)
Unknown risk:
HBV naïve donor into HbcAb + recipient	None	None

Ab: Antibody; ETV: Entecavir; HBIG: Hepatitis B immune globulin; HBc: Hepatitis B core; HBV: Hepatitis B virus; HCC: Hepatocellular carcinoma; HDV: Hepatitis D (delta agent); LT: Liver transplantation; NAs: Nucleotide analogues; TFV: Tenofovir; HIV: Human immunodeficiency virus.