Norah A. Terrault, MD - Managing HBV Infection Following Liver Transplant: Expert Q&A

Jasenka Piljac Žegarac, PhD
March 05, 2018

Managing HBV Infection Following Liver Transplant: Expert Q&A
In an interview with Infectious Disease Advisor, Norah A. Terrault, MD, MPH, professor of medicine and director of the Viral Hepatitis Center at the University of California, San Francisco (UCSF), discussed the recent advances and remaining challenges in managing HBV infection in patients undergoing liver transplantation.

Infectious Disease Advisor: What is the primary indication for liver transplantation in patients with HBV infection?

Norah A. Terrault, MD, MPH: In our transplant center at UCSF, as in others throughout the United States, the majority of patients with HBV have liver cancer as the primary indication for liver transplantation.7 The other group of patients in whom we perform liver transplants are patients with acute liver failure due to hepatitis B and those with decompensated cirrhosis. For those with decompensated cirrhosis, these are frequently patients with HBV who present very late to care and who have been undiagnosed and untreated for a very long time. However, anyone who is engaged in care and having their hepatitis B appropriately managed is generally at low risk of getting decompensated cirrhosis, because current guidelines recommend that patients who have cirrhosis and HBV continue with antiviral therapy for life. Long-term suppressive antiviral therapy would be expected to prevent progression of cirrhosis and decompensated liver disease.

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Of Interest
Developing a New Combination Treatment for HBV Infection
NVR3–778, a capsid assembly modulator, reduces serum levels of hepatitis B virus (HBV) DNA and HBV RNA in mice with humanized livers and stable HBV infection, researchers report in the February issue of Gastroenterology. The combination of NVR3–778 and interferon prevented viral replication and HBV RNA particle production to a greater extent than either compound alone or entecavir.

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