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Chronic hepatitis B virus (HBV) infection previously was considered to be a contraindication to liver transplant because of high risk for recurrent HBV infection, which could lead to rapid allograft failure and death. Recurrent infection can now be prevented with the use of lamivudine plus high-dose intravenous hepatitis B immunoglobulin (HBIG), allowing for safe transplantation, but this regimen is quite expensive (US$50,000–$75,000 for the first year and $25,000–$40,000 annually thereafter). Seeking an alternative, investigators in Australia evaluated the long-term safety and efficacy of lamivudine plus low-dose intramuscular HBIG.
This retrospective study involved 147 patients (median age, 49; 86% men; 39% Asian; 28% Polynesian) who under…