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Among patients with chronic hepatitis B virus (HBV) infection, recurrence of infection after liver transplantation is associated with allograft failure and death. The use of lamivudine plus high-dose intravenous hepatitis B immunoglobulin (HBIG) has reduced the 5-year recurrence rate to <5%, allowing routine transplantation for these patients. Unfortunately, this regimen costs US$50,000 to $75,000 for the first year and $25,000 to $40,000 annually thereafter. Recent studies have shown that low-dose intramuscular HBIG plus lamivudine is as effective as this regimen — and considerably less expensive (JW Gastroenterol Jun 8 2007).
Now, researchers have evaluated the efficacy of a more potent antiviral agent, entecavir, without HBIG. The study i…