Dual therapy with nucleos(t)ide analogues in the prevention of hepatitis B virus recurrence after liver transplantation:Two case reports  

作　　者：Nicolás Ortiz-López Maximiliano Acevedo Tamara Vergara Juan Pablo Roblero Álvaro Urzúa Máximo Cattaneo Jaime Poniachik 

机构地区：[1]Sección de Medicina Interna,Hospital Clínico Universidad de Chile,Santiago 8380453,Región Metropolitana,Chile [2]Escuela de Medicina,Universidad de Chile,Santiago 8380453,Región Metropolitana,Chile [3]Sección de Gastroenterología,Hospital Clínico Universidad de Chile,Santiago 8380453,Región Metropolitana,Chile

出　　处：《World Journal of Hepatology》2025年第4期144-150,共7页世界肝病学杂志(英文)

摘　　要：BACKGROUND Infection by the hepatitis B virus(HBV)represents a significant global sociosanitary burden.While liver transplantation(LT)is an important therapeutic option,treatments that prevent HBV reinfection are necessary.The combination of anti-hepatitis B immunoglobulin(HBIG)and nucleoside/nucleotide analogs(NA)is the standard post-transplant treatment;however,there are limitations in using HBIG,particularly its cost.We present two illustrative clinical cases as examples of post-transplant management using dual NA therapy,unaccompanied by HBIG.CASE SUMMARY The first case involves a 42-year-old man with HBV-related cirrhosis,who,in the context of a diagnosis of hepatocellular carcinoma and hepatopulmonary syndrome,underwent LT without viremia at the time of transplantation.A lack of availability of HBIG led to the combined use of two NAs,entecavir,and tenofovir alafenamide—resulting in the negativization of hepatitis B surface antigen(HBsAg)and maintenance of a negative viral load in the post-transplant period.In the second case,a 63-year-old woman presented with acute hepatic failure due to HBV with viremia during transplantation.Combined therapy with entecavir and tenofovir alafenamide,again due to the unavailability of HBIG,ultimately led to the negativization of HBsAg and viral load.CONCLUSION These cases suggest the efficacy of dual NA therapy in post-transplant HBV management,emphasizing the need to reconsider traditional treatment approaches.

关 键 词：Antiviral drug Liver transplant Hepatitis B virus Viral recurrence Nucleoside analog Case report 

分 类 号：R657.3[医药卫生—外科学]