Hepatitis Antigen Levels Guide Dosing Post Liver Transplant

Preoperative HBsAg levels correlate with postoperative HBIG doses required for clinical activity

FRIDAY, April 27 (HealthDay News) -- The preoperative level of hepatitis B surface antigen (HBsAg) in hepatitis B virus-infected patients undergoing liver transplantation determines the dose of hepatitis B immunoglobulin (HBIG) required to reduce HBsAg levels and raise anti-HBs postoperatively, researchers report in the April issue of the Journal of Hepatology.

In the study, Jens Rosenau, M.D., of Medizinische Hochschule Hannover in Germany, and colleagues compared a dosing schedule of 10,000 IU HBIG in the anhepatic phase followed by 10,000 IU daily until HBsAg became negative for 13 patients, to 20,000 IU followed by 5,000 IU every 30 minutes in five other patients undergoing transplantation.

The investigators found a high correlation of preoperative HBsAg levels with both the amount of HBIG required to reduce HBsAg by 1 IU/mL and with the amount required to raise anti-HBs above 1,000 IU/L. The effect was apparent for both treatment groups. Also, patients with detectable hepatitis B virus DNA had reduced or negative DNA levels following treatment. The researchers also found that smaller HBIG dosing intervals accelerated the decline of HBsAg and the increase of anti-HBs.

"Quantitative monitoring of hepatitis B virus DNA, anti-HBs, and HBsAg provides a basis for designing further studies to evaluate a rational individualized parameter-oriented HBIG dosing during anhepatic and early postoperative phase," the authors write.

Biotest GmbH provided funding for the study. One author is an employee of Abbott GmbH.

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