Presenter: Marina, Berenguer, Valencia, Spain
Prior to the early 90s, and in the absence of any prophylaxis, survival for HBV was significantly lower than that achieved by other indications, and this was caused by HBV recurrence occuring in greater than 80% of cases. For this reason, HBV disease was considered a contraindication for liver transplantation in many centers. In only ten years, hepatitis B has become a universally accepted indication with results similar to or even better than those obtained by patients transplanted for other indications. The first major advance was the introduction of hepatitis B immunoglobulins (HBIg) prophylaxis with an average risk decreased of HBV recurrence from 75% to 30%. More recently, the results have further improved, with the introduction of oral antivirals, such that the combination of HBIg with antivirals, has further reduced the rate of HBV recurrence to less than 10%. Despite the fact that current schedules of HBV prophylaxis are very effective, several strategies are being attempted to maximize the cost-benefit, particularly approaches to reduce and/or discontinue HBIG, considered a costly and cumbersome product.
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