Patterns of hepatitis delta virus reinfection and disease in liver transplantation.

Abstract:

:Twenty-seven carriers of the hepatitis B surface antigen who underwent liver transplantation in Italy and Belgium for terminal Hepatitis delta virus (HDV) cirrhosis were investigated. In 22 of the patients, HDV infection recurred. Two patients died of coexisting HDV and hepatitis B virus (HBV) reactivation. Four patients who died of unrelated causes were found to have HDV without signs of HBV reactivation. Five patients (18%) cleared both HBV and HDV after transplantation with no evidence of hepatitis (mean follow-up, 29 months). In many surviving patients. HDV infection recurred early without signs of HBV reactivation. Disease returned in the 11 HDV-infected patients in whom HBV also recurred. Histological hepatitis did not recur during an interim of 12-33 months in the 5 HDV-infected patients in whom HBV did not return. The overall medium-term survival in patients with HDV who underwent transplantation was 77.7%. Liver transplantation offers patients with HDV a hope of cure from disease despite a high risk of reinfection. In the transplantation setting. HDV can cause subclinical infections without any apparent assistance from HBV; these infections become symptomatic only if and when HBV reactivates. Thus, HDV may not be in itself pathogenic but requires cooperation from HBV to cause the appearance of the disease.

journal_name

Gastroenterology

journal_title

Gastroenterology

authors

Ottobrelli A,Marzano A,Smedile A,Recchia S,Salizzoni M,Cornu C,Lamy ME,Otte JB,De Hemptinne B,Geubel A

doi

10.1016/0016-5085(91)90404-9

subject

Has Abstract,Author List Incomplete

pub_date

1991-12-01 00:00:00

pages

1649-55

issue

6

eissn

0016-5085

issn

1528-0012

pii

0016-5085(91)90404-9

journal_volume

101

pub_type

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