Ann Surg Treat Res.  2015 Sep;89(3):145-150. 10.4174/astr.2015.89.3.145.

De novo hepatitis B virus infection developing after liver transplantation using a graft positive for hepatitis B core antibody

Affiliations
  • 1Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. kimdg@catholic.ac.kr
  • 2Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The use of hepatitis B core antibody (HBcAb)-positive grafts is increasing, especially where hepatitis B is endemic. However, this remains controversial because of the risk of development of de novo HBV infection.
METHODS
We collected information obtained between January 2000 and December 2012 and retrospectively analyzed data on 187 HBsAg-negative donors and recipients were analyzed retrospectively. De novo HBV infection was defined as development of HBsAg positivity with or without detection of HBV DNA.
RESULTS
Forty patients (21.4%) received HBcAb-positive grafts. Survival rate did not differ by donor HBcAb status (P = 0.466). De novo HBV infection occurred in five patients (12.5%) who were not treated with anti-HBV prophylaxis, and was significantly more prevalent in hepatitis B surface antibody (HBsAb)- and HBcAb-negative than HBsAb- and HBcAb-positive recipients (50% vs. 4.2%, P = 0.049). All patients except one were treated with entecavir with/without antihepatitis B immunoglobulin and four were negative in terms of HBV DNA seroconversion. No patient died.
CONCLUSION
HBcAb-positive grafts are safe without survival difference. However, the risk of de novo hepatitis B virus infection was significantly increased in HBsAb- and HBcAb-negative recipients. All patients were successfully treated even after recurrence.

Keyword

Hepatitis B antibodies; de novo hepatitis B; Liver transplantation; Prognosis

MeSH Terms

DNA
Hepatitis B Antibodies
Hepatitis B Surface Antigens
Hepatitis B virus*
Hepatitis B*
Hepatitis*
Humans
Immunoglobulins
Liver Transplantation*
Liver*
Prognosis
Recurrence
Retrospective Studies
Survival Rate
Tissue Donors
Transplants*
DNA
Hepatitis B Antibodies
Hepatitis B Surface Antigens
Immunoglobulins
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