Copyright ©The Author(s) 2020.
World J Gastroenterol. May 14, 2020; 26(18): 2166-2176
Published online May 14, 2020. doi: 10.3748/wjg.v26.i18.2166
Table 1 Main virological and biochemical features in the different clinical phases of chronic hepatitis B in HBsAg+ patients
Phase 1: Immune tolerantPhase 2: Immune activePhase 3: Asymptomatic carrierPhase 4: HBV reactivation
HBeAg+Attempt to remove HBeAgHBeAg-HBeAg+ or -
Normal LFTs→ no damageAltered LFTs→ damageNormal LFTs→ no damageAltered LFTs→ damage
Table 2 Main studies examining prophylaxis minimization in hepatitis B virus liver transplanted patients, employing different approaches
Specific aimRef.Number of patientsMethodMain results
HBIG minimizationDi Paolo et al[71]11HBIG administration on demand (when HBsAb < 70 IU/L) with LamNo HBV reactivation (1 yr F/U)
Gane et al[72]147Very-low HBIG dose (400-800 IU monthly) with Lam4% of HBV recurrence (5 yr F/U)
High-genetic barrier nucleos(t)ide analogues monotherapyFung et al[73,74]80ETV monotherapy92% HBsAg-100%HBV-DNA undetectable (8 yr F/U)
Teperman et al[75]40TDF monotherapy after HBIG discontinuationNo change (72 wk F/U)
Manini et al[77]77ETV or TDF monotherapy after HBIG discontinuation100%HBV-DNA undetectable 9% HBsAg reappearance (5 yr F/U)
Complete withdrawal of HBV prophylaxisLenci et al[81,82]30Sequential discontinuation of HBIG and Lam in low risk (cccDNA negative) patients90% successful withdrawal 60% HBsAb > 10 IU (6 yr F/U)