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Hepatitis B virus reinfection after orthotopic liver transplantation. Serological and clinical implications.

Abstract：

:The implications of hepatitis B virus (HBV) reinfection after liver transplantation were studied in 29 patients followed for 1.7-15 years. Of 20 patients with HBV infection alone, nine were HBeAg and HBV DNA seronegative and 11 had evidence of HBV replication as measured by HBeAg or HBV DNA seropositivity. Nine patients had co-existing HBV and delta virus (HDV) infection. Five patients became HBsAg seronegative after transplantation (four immediately and one after an hepatitic episode). Of the 20 patients with HBV infection alone, 17 had evidence of viral replication after transplantation with markedly increased HBV DNA levels. Five patients with HDV infection had HBV DNA in serum, but in significantly lower amounts than in those with HBV infection alone. Twenty-five episodes of graft dysfunction attributed to recurrent HBV infection occurred in 19 patients (65.5%). Thirteen episodes (in 12 patients) were self-resolving acute hepatitic illnesses. Six patients had a rapidly progressive illness leading to graft loss within 6 weeks, with the distinctive histological features termed fibrosing cholestatic hepatitis (FCH). Liver function tests in these patients showed markedly abnormal serum bilirubin and prothrombin times, but only modest increases in serum transaminase levels. An additional six patients lost their graft as a consequence of HBV recurrence through various pathogenetic mechanisms including possible (but unproven) FCH, chronic active hepatitis or late-onset hepatic failure. Co-existing HDV infection appeared to confer some medium-term protection from graft loss.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

O'Grady JG,Smith HM,Davies SE,Daniels HM,Donaldson PT,Tan KC,Portmann B,Alexander GJ,Williams R

doi

10.1016/0168-8278(92)90138-f

subject

Has Abstract

pub_date

1992-01-01 00:00:00

pages

104-11

issue

1

eissn

0168-8278

issn

1600-0641

pii

0168-8278(92)90138-F

journal_volume

14

pub_type

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