Methods: The study population consisted of 52 HBsAg- naive recipients (median age 59 yrs, 73% male) of HBcAb+ livers who underwent see more liver transplantation (LT) between 1/1/1999 and 12/31/2011. All of them had received LAM to prevent HBV infection, defined as detection of HBsAg on at least two consecutive occasions. Results: After a median post-LT follow-up of 3.8 years (range: 0.1-11.6 yrs), 7 (13.5%) patients developed HBV infection at a median of 2 years (range: 1-6.5 yrs) after LT: in 3 cases after accidental LAM withdrawal (8, 9, and 12 months after LT) and while on continued LAM therapy in the remaining 4 cases. The cumulated probability

rates of HBV infection were 2%, 13%, 17%, and 23% at 1, 3, 5, and 10 years, respectively. HBsAg positivity was accompanied by elevated serum HBV DNA levels in six cases and by increased ALT levels in 2 cases. LAM-specific mutations were found only in the 4 patients who developed HBV infection while on continued LAM therapy. Initial HBV therapy consisted of tenofovir +/− LAM (n=4), LAM +/− ADV (n=2), and entecavir

(n=1), respectively. Mean time from HBV infection to start of HBV therapy was 64 days (range: 1-321 days). In addition, persistent seroreversion of anti-HBc after LT was detected in four (11%) of the 45 patients who remained HBsAg- after LT. Overall, 17 (33%) of the 52 patients died. Patient survival rates were 94%, 74%, and 55% PLX4720 at 1, 5, and 10 years, respectively, with no deaths due to hepatitis B. Conclusions. HBV infection either overt or cryptic is frequently observed with prolonged follow-up in HBsAg-negative naive recipients of HBcAb+ grafts treated with lamivudine. Based on these findings, alternative MCE agents, such as entecavir or tenofovir, should be used as HBV prohylaxis in these patients. Disclosures: Martin Prieto – Advisory Committees or Review Panels:

Bristol, Gilead The following people have nothing to disclose: María García Eliz, Ana M. Braithwaite, Angel Rubin, Victoria Aguilera, Salvador Benlloch, Marina Berenguer, Carmen Vinaixa Background Before the introduction of combined reinfection prophylaxis in patients after liver transplantation (LTX) for hepatitis B survival rates were low. This was mainly due to a high rate of HBV recurrence. Current reinfection prophylaxis consists of hepatitis B immunoglobuline (HBIG) in combination with a nucleos(t)ide analog (NUC). However, high costs of HBIG, laborious administration and repeated testing of anti-HBs titers are restrictive. Aim The aim of this prospective single-arm open label pilot study was to investigate the effect of early HBIG withdrawal within 3 months following LTx and continued entecavir mono therapy on HBV reinfection after 48 and 96 weeks. Methods & Patients 20 HBV-positive patients with LTx at two centers were recruited prospectively between 2010 and 2013. Perioperative care was performed according to local standard.