Current and Potential Future Chemopreventive Strategies Against Hepatitis B Virus Reinfection in Liver Transplant Recipients

Although the availability of effective oral therapies for hepatitis B virus (HBV) infection has reduced the need for liver transplantation (LT) for decompensated cirrhosis due to chronic infection, HBV remains an important cause of hepatocellular carcinoma and acute liver failure. Recurrent HBV infection occurs almost invariably post-LT in the absence of prophylaxis if viremia was detectable pre-LT, so prophylaxis remains necessary to prevent graft reinfection. Current approaches include the use of nucleos(t)ide analogues pre- and post-LT and hepatitis B immune globulin, but several novel antiviral agents are currently under investigation in non-transplant populations and may potentially prove to be useful in the LT setting in the future.