Topic Highlight
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2016; 22(1): 165-175
Published online Jan 7, 2016. doi: 10.3748/wjg.v22.i1.165
Prophylactic managements of hepatitis B viral infection in liver transplantation
Takashi Onoe, Hiroyuki Tahara, Yuka Tanaka, Hideki Ohdan
Takashi Onoe, Division of Applied Immunobiology, Institute for Clinical Research, National Hospital Organization, Kure Medical Center/Chugoku Cancer Center, Hiroshima 737-0023, Japan
Takashi Onoe, Hiroyuki Tahara, Yuka Tanaka, Hideki Ohdan, Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
Author contributions: Onoe T performed the literature search, wrote the first draft of the manuscript, and approved the final version; Tahara H performed the literature search; Tahara H, Tanaka Y and Ohdan H edited the final draft of the manuscript and approved the final version.
Supported by A Grant-in-Aid for the Research of Hepatitis and BSE from the Japanese Ministry of Health, Labour and Welfare.
Conflict-of-interest statement: All authors declare no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Takashi Onoe, MD, PhD, Head, Division of Applied Immunobiology, Institute for Clinical Research, National Hospital Organization, Kure Medical Center/Chugoku Cancer Center, 3-1 Aoyama-cho, Kure, Hiroshima 737-0023, Japan. tonoemd@gmail.com
Telephone: +81-82-3223111 Fax: +81-82-3210478
Received: May 18, 2015
Peer-review started: May 20, 2015
First decision: August 26, 2015
Revised: November 11, 2015
Accepted: December 14, 2015
Article in press: December 14, 2015
Published online: January 7, 2016
Core Tip

Core tip: Combination therapy consisting of high-dose hepatitis B immunoglobulin (HBIG) and lamivudine has been the standard prophylaxis for hepatitis B virus recurrence after liver transplantation. Currently, after development of more potent high genetic barrier nucleos(t)ide analogues (hgbNAs), such as entecavir and tenofovir disoproxil fumarate, combination therapy using low-dose HBIG and hgbNA is considered as the most efficacious and cost-effective prophylaxis. In addition, monotherapy with hgbNAs and withdrawal of HBIG following combination therapy of HBIG and hgbNAs could be promising approaches, especially for low-risk patients and those receiving grafts from hepatitis B core antibody-positive donors. This review discusses those approaches including other challenging therapeutic options.