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Combo Therapy Improves Survival in Hepatitis B

Adding lamivudine to hepatitis B immunoglobulin decreases recurrence and mortality in liver transplant patients

THURSDAY, July 3 (HealthDay News) -- Combining hepatitis B immunoglobulin (HBIG) and lamivudine significantly improves prevention of hepatitis B virus (HBV) recurrence, HBV-related death and all-cause mortality in the post-liver transplantation setting, according to an article published in the June issue of Clinical Gastroenterology and Hepatology.

Rohit Loomba, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Md., and colleagues performed a meta-analysis of clinical trials with patients receiving HBIG and lamivudine versus HBIG alone in order to estimate HBV recurrence and HBV-related morbidity and mortality post-liver transplant. Two prospective and four retrospective studies with 193 patients receiving HBIG plus lamivudine and 124 patients receiving HBIG monotherapy were used in the analysis.

HBV recurrence in the combination therapy group was 4.1 percent versus 36.1 percent in the HBIG monotherapy group, the investigators report. Combination therapy was also associated with less HBV-related death than HBIG monotherapy (0.8 percent versus 15.1 percent, respectively) and all-cause mortality (5.1 percent versus 22.2 percent, respectively).

Despite the meta-analysis demonstrating the superior effect of combination therapy, "further research is needed to determine the duration of HBIG after liver transplant and whether HBIG can be stopped or patients can be switched to lower doses of HBIG after a defined period of time after liver transplant," according to the authors.

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