Long-term clinical and virological outcome after liver transplantation for cirrhosis caused by chronic delta hepatitis

Abstract

Liver transplantation for liver diseases related to hepatitis B virus (HBV) and hepatitis delta virus (HDV) remains problematic because of the risk of viral recurrence. We report here the long-term virological outcome of patients transplanted for HDV-related liver cirrhosis (HDV cirrhosis). From December 1984 to December 1990, 76 patients with HDV cirrhosis underwent liver transplantation. Before transplantation, all the patients were HBsAg-positive/anti-HDV positive, and all but one were HBV DNA-negative by dot blot hybridization. HDV RNA was detected by HDV RT-PCR and liver HDAg by fluorescent HDV Ab. After transplantation, all the patients except four received continuous long-term anti-HBs passive immunoprophylaxis. The actuarial 5-year survival was 88%. All patients who did not receive anti-HBs immunoprophylaxis remained HBsAg-positive and developed hepatitis. Among the 68 patients receiving antiHBs immunoprophylaxis with a minimum follow-up of 2 months, HBsAg reappeared in 7 (10.3%) after a mean of 17 months. These seven patients developed hepatitis, with simultaneous HBV and HDV replication; and four cleared later HBsAg. Patients without HBV reinfection were studied for HDV reinfection: liver HD Ag or serum HDV RNA were present in 88% of the patients during the first year, without developing hepatitis; however, they were no longer detectable after 2 years in 95% of the patients. In conclusion, liver transplantation for HDV cirrhosis gives good results, with a 5-year actuarial survival of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

Combination Low-Dose Hepatitis B Immune Globulin and Lamivudine Therapy Provides Effective Prophylaxis Against Posttransplantation Hepatitis B

“…That this did not occur would be consistent with an additive antiviral effect of low-dose HBIG therapy. Although coinfection with HCV and HDV may reduce HBV replication and the subsequent risk for recurrent infection, 14,15 this group made up less than 10% of the patients in our study and would not have substantially influenced the results.…”

Hepatite D

“…Com relação à distribuição geográfica dos genótipos do VHD, observe que o tipo I prevalece nos Estados Unidos da América do Norte 7 , Europa 32 , Norte da África 53 , Ásia 49 50 e Sul do Pacífico 46 . Descreveu-se o tipo II na Ásia, especialmente no Japão e Taiwan 49 50 , enquanto o tipo III tem sido relatado apenas na América do Sul 8 39 .…”

Microsatellite instability in European hepatocellular carcinoma

“…Finally, 46 pairs of tumour and nontumour liver samples from 46 Caucasian patients (39 males, 7 females, aged 18 ± 75 years) were analysed. All patients were tested serologically for hepatitis B, D and C viruses as published elsewhere (Samuel et al, 1995;Feray et al, 1994). In six of them (13%), HCC was associated with hepatitis B, in one (2%) with hepatitis B+D, in ®ve (11%) with hepatitis B+C and in 13 (28%) with hepatitis C virus infection alone.…”