Occult hepatitis B virus infection in liver transplant recipients with recurrent hepatitis C: relationship with donor age and fibrosis progression

Abstract

Liver transplantation (OLT) recipients who receive a graft from donors positive for hepatitis B virus (HBV) anti-core antibodies may develop overt "de novo" HBV infection. The study was undertaken to explore how often HBV infection may remain occult after OLT for hepatitis C, and whether it may represent a factor of graft fibrosis progression. We studied 30 consecutive patients transplanted for hepatitis C liver disease. Specimens from the native liver and from the graft were searched for occult HBV infection (O-HBV). In the native liver, 8/30 patients had detectable O-HBV; during the follow-up, O-HBV infection was demonstrated in 14 graft specimens. Graft O-HBV was associated with older donor age (> or =50 yr; 8/9 vs. 6/21, p < 0.005). Recipients with graft O-HBV and no O-HBV in the native liver who received their grafts from donors aged >40 yr had faster fibrosis progression than recipients with no post-transplant O-HBV, whose grafts came from donors aged >40 yr and recipients whose grafts came from donors aged < or =40 yr (4/7 vs. 1/7 vs. 2/16, p < 0.05). In OLT recipients, O-HBV is more likely to occur when grafts are obtained from aged donors and may affect the rate of fibrosis progression because of recurrent hepatitis C.

Molecular characterization of occult hepatitis B virus infection in patients with end-stage liver disease in Colombia

“…These results are agree with previous reports of OBI with HCV coinfection and cryptogenic liver disease [21, 48, 49, 82, 86]. …”

“…The OBI frequency described in the present study population (10%) is similar to other reports of OBI in a country of the region, Brazil (4.4% to 17.64%) that showed the impact of this infection in patients with diagnosis of end-liver disease [28, 48, 49, 82]. …”

“…Taking these results in account, OBI diagnosis should be considered in patients with cryptogenic or HCV associated end-stage liver disease before liver transplantation in order to decide what therapeutic strategy should be applied for these patients [47, 48, 87]. …”

Okült Hepati̇t B Vi̇rus Enfeksi̇yonu: Moleküler Mekani̇zmalar Ve Kli̇ni̇k Önemi̇

“…Okült B'li karaciğer ve/ya organ alıcılarında OBİ'li donörden organ nakli sonrası, alıcının yeni karaciğer dokusunda alıcı veya donöre ya da her ikisine ait HBV sekanslarını içeren (ek olarak HBV cccDNA) OBİ varlığı tespit edilebilmekte (64), fakat bu durumun nakil sonrası dönemde HCV pozitif hastalarda progresyon artışına neden olabildiğine dair kısmi verilerin dışında klinik önemi henüz bilinmemektedir. Ayrıca Hepatit B immünglobulin ve lamivudin tedavisi alan nakil sonrası dönemde HBsAg'si negatifleşen HBsAg pozitif organ alıcılarında da OBİ gelişebildiği rapor edilmektedir (64,65). (66)(67)(68).…”

Occult Hepatitis B infection and immunity

“…OBI may favor or accelerate the progression toward cirrhosis, associated with the most severe forms of liver disease in HCV-infected patients. Preliminary evidence suggests a possible involvement in faster progression of posttransplant liver disease in HCVpositive patients with OBI in donor or recipient (Toniutto et al, 2009).…”