肝移植患者乙型肝炎病毒再感染的防治

目的 预防和早期诊断肝移植患者术后乙型肝炎病毒（ＨＢＶ）再感染和乙型肝炎（乙肝）的复发，以及探讨肝炎复发后的进一步治疗。方法 肝移植患者术后常规采用拉米夫定预防ＨＢＶ再感染，同时监测肝功能、乙型肝炎血清标记物、血清ＨＢＶ－ＤＮＡ、肝活检组织乙型肝炎标记物免疫组化。结果 ４例患者出现ＨＢＶ再感染，其中２例表现为复发的乙型肝炎，经治疗后，２例复发的乙肝患者１例继续发展成为慢必 症肝炎，１例好转。结论

Prevention and trealment of hepatitis B virus reinfection following liver transplantation

Objective To prevent and early diagnose hepatitis B virus(HBV) reinfection and recurrent hepatitis B following liver transplantation.and to discuss the further treatment of recurrent hepatitis B.Methods Patients undergoing liver transplantation received lamivudine to prevent HBV reinfection.Virological and biochemical data,serum HBV-DNA,and immunohistological staining for HBsAg and HBcAg in biopsy liver tissue were tested in due time.Results Of 4 cases diagnosed as having HBV reinfection,two presented hepatitis B recurrence after liver transplantation:One developed to chronic severe hepatitis B after great efforts of treatment and one improved after a series of treatment.Conclusions HBV reinfection or recurrent hepatitis B following liver transplantation occurred mostly about 6 to 12 months after operation.It should be considered hepatitis B recurrence when liver biochemistrical data became poor during this period.The treatment for recurrent hepatitis B after liver transplantation included increasing dosage of lamivudine.application of famciclovir,and other liver protective measures.