A 46-year-old female patient with a history of pulmonary tuberculosis and acute hepatitis at 6 years of age.
In 2001 he was diagnosed with liver cirrhosis complicated with spontaneous bacterial peritonitis.
The etiologic study showed chronic HBV hepatitis with HBsAg, total AntiHBc, and HBeAg positive (IAMIx Abbott; ELFA miniVIDAS, BioMerieux).
Subsequently, it presented several complications associated with portal hypertension, so it was considered a liver transplant.
In November 2003, treatment with lamivudine 150 mg/day was initiated, achieving HBV-DNA negativization by polymerase chain reaction (PCR) techniques.
On April 1, 2004, liver transplantation was performed, during the anhepatic phase and in the immediate postoperative period HBIg was administered (Grifols® for IM use) 5000 c lamivudine in saline solution diluted in 300 c.
Subsequent doses of HBIg were calculated according to anti-HBs antibody titers (EIA, IMx Abbott) Table 1.
Treatment with methyl prednisolone and cyclosporine was initiated, followed by oral prednisone and cyclosporine, associated with isoniazid chemoprophylaxis during the first six months after transplantation.
The patient was discharged home on the twelfth day after transplantation.
Subsequently, she received HBIg weekly during the first month, and then monthly (2,000 U IM) maintaining lamivudine 150 mg/day.
To date, HBsAg is undetectable.
