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    HBV Infection-Monitoring Before and After Liver Transplantation

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    Megen PLC
    This document outlines monitoring guidelines for patients with chronic hepatitis B virus (HBV) infection both before and after liver transplantation. It recommends obtaining baseline HBV DNA levels and monitoring every 2-3 months pre-transplant. For transplant, HBV DNA levels should be measured and post-transplant treatment and monitoring depends on if levels are above or below 10^4 IU/mL. Ongoing monitoring of HBV DNA, HBs antigen, and antibodies is recommended long-term to detect reinfection and guide treatment changes if needed.

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    HBV Infection-Monitoring Before and After Liver Transplantation

    Uploaded by

    Megen PLC
    14 views1 page
    This document outlines monitoring guidelines for patients with chronic hepatitis B virus (HBV) infection both before and after liver transplantation. It recommends obtaining baseline HBV DNA levels and monitoring every 2-3 months pre-transplant. For transplant, HBV DNA levels should be measured and post-transplant treatment and monitoring depends on if levels are above or below 10^4 IU/mL. Ongoing monitoring of HBV DNA, HBs antigen, and antibodies is recommended long-term to detect reinfection and guide treatment changes if needed.

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    HBV_Infection-Monitoring_Before_and_After_Liver_Transplantation

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    This document outlines monitoring guidelines for patients with chronic hepatitis B virus (HBV) infection both before and after liver transplantation. It recommends obtaining baseline HBV DNA levels and monitoring every 2-3 months pre-transplant. For transplant, HBV DNA levels should be measured and post-transplant treatment and monitoring depends on if levels are above or below 10^4 IU/mL. Ongoing monitoring of HBV DNA, HBs antigen, and antibodies is recommended long-term to detect reinfection and guide treatment changes if needed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    14 views1 page

    HBV Infection-Monitoring Before and After Liver Transplantation

    Uploaded by

    Megen PLC
    This document outlines monitoring guidelines for patients with chronic hepatitis B virus (HBV) infection both before and after liver transplantation. It recommends obtaining baseline HBV DNA levels and monitoring every 2-3 months pre-transplant. For transplant, HBV DNA levels should be measured and post-transplant treatment and monitoring depends on if levels are above or below 10^4 IU/mL. Ongoing monitoring of HBV DNA, HBs antigen, and antibodies is recommended long-term to detect reinfection and guide treatment changes if needed.

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    © All Rights Reserved
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    of 1

    HBV Infection–Monitoring Before and After Liver Transplantation

    Pretransplant
    Chronic HBV with end-stage liver disease (ESLD)

    Obtain baseline HBV DNA level using


    HBVQN / Hepatitis B Virus (HBV) DNA Detection
    and Quantification by Real-Time PCR, Serum

    Anti-HBV drug treatment of choice

    Order HBVQN / Hepatitis B Virus (HBV) DNA


    Detection and Quantification by Real-Time
    PCR, Serum every 2 to 3 months

    Transplant

    Order HBVQN / Hepatitis B Virus (HBV)


    DNA Detection and Quantification by
    Real-Time PCR, Serum at transplant

    HBV DNA <104 IU/mL HBV DNA >104 IU/mL

    ■ Initiate hepatitis B immune globulin (HBIG) therapy for 1 ■ Initiate and continue hepatitis B immune globulin (HBIG)
    month therapy indefinitely
    ■ Continue anti-HBV drug treatment of choice ■ Continue anti-HBV drug treatment of choice
    ■ Order HBABT / Hepatitis B Surface Antibody Monitor, ■ Order HBABT / Hepatitis B Surface Antibody Monitor Post-
    Post-Transplant, Serum to guide HBIG dosing Transplant, Serum to guide HBIG dosing
    ■ Order HBs antigen (HBAG / Hepatitis B Surface Antigen, ■ Order HBs antigen (HBAG / Hepatitis B Surface Antigen,
    Serum) and HBV DNA (HBVQN) per transplant protocol Serum) and HBV DNA (HBVQN) per transplant protocol

    Negative HBs antigen: Positive HBs antigen: Negative HBs antigen:


    No reinfection HBV reinfection No reinfection

    ■ Order HBs antigen (HBAG) and ■ Order HBVQN Continue anti-HBV prophylaxis
    HBV DNA (HBVQN) per transplant ■ Change anti-HBV drug therapy to an alternative and monitor every 3 to 6
    protocol nucleos(t)ide analog months using HBVQN
    ■ Administer HBV vaccine (optional) ■ Consider hepatitis B virus (HBV) drug resistance test
    to guide therapy. Contact Mayo Clinic Laboratories to
    order.

    ■ Monitor treatment response every 3 to 6 months by


    ordering HBVQN
    ■ If resistance to a nucleos(t)ide analog is suspected,
    consider hepatitis B virus (HBV) drug resistance test.
    Contact Mayo Clinic Laboratories to order.

    Reviewed 01/2022
    © Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. 01/2018

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