De Novo HBV Infection Caused by an Anti-HBc Positive Donor in a Vaccinated Liver Transplant Recipient In Spite of Anti-HBs Response

Liver transplant from Anti‐HBc‐positive, HBsAg‐negative donor into HBsAg‐negative recipient: is it safe? A systematic review of the literature

“…The studies were conducted in North American, European, Australian and Asian transplant centers and included seven case reports (11)(12)(13)(14)(15)(16)(17), three case series with five patients or less (6,18,19) and only six prospective cohorts (20)(21)(22)(23)(24)(25).…”

“…However, there are two reports of de novo infection in previously vaccinated patients, as a result of the emergence of ÔÔaÕÕ determinant mutated strains of HBV (15,16). Nucleoside analogs should be used judiciously to prevent drug resistance after prolonged use in cases of de novo HBV infection; as a result, revaccination would be a reasonable option to maintain high levels of Anti-HBs titers in children.…”

False-Negative Hepatitis B Virus (HBV) Surface Antigen in a Vaccinated Dialysis Patient with a High Level of HBV DNA in the United States

“…In "false" occult HBV infections, HBV variants with mutations occurring in the S gene produce an altered HBsAg that goes undetected by several commercially available FDA-approved assays but maintain viral loads consistent with active infection (16). Though these variants have been reported in European, African, and Asian patient populations (19), these mutants have been described only in limited numbers in the United States, among liver transplant recipients with previously known history of HBV infection or in the setting of donor-positive hepatitis B core antibody and de novo infection despite previous vaccination in the recipient (7,14). In this patient, the circulating levels of anti-HBs would typically confer immunity.…”

Liver Transplantation Using Hepatitis B Core Antibody−Positive Grafts: Review and University of Tokyo Experience

“…They immunized 14 recipients with 40-µg hepatitis B vaccinations three times with a 15-day interval, although the vaccine response rate was not described. One of the 14 recipients developed de novo HBV infection after receiving an HBcAb-positive liver; this might have occurred because of an immune escaped HBV mutant with a structural variation in the epitope of the surface antigen recognized by the HBsAb [41,42].…”