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Hepatitis B virus precore mutant infection is associated with severe recurrent disease after liver transplantation
Author(s) -
Angus Peter W.,
Locarnini Stephen A.,
McCaughan Geoffrey W.,
Jones Robert M.,
McMillan Janine S.,
Bowden D. Scott
Publication year - 1995
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840210104
Subject(s) - hepatitis b virus , medicine , liver transplantation , transplantation , liver disease , virology , virus , hepatitis b , orthohepadnavirus , polymerase chain reaction , hepatitis , gastroenterology , hepadnaviridae , immunology , biology , gene , biochemistry
The factors that predispose patients undergoing liver transplantation for hepatitis B virus (HBV) disease to severe recurrence of infection are unclear. In this study we examined the effect of pretransplantation infection with HBV and precore variant strains of HBV on posttransplantation outcome and allograft histology in 24 patients who survived more than 3 months after liver transplantation. Based on pretransplantation serum HBV DNA status as detected by the polymerase chain reaction (PCR) and direct sequencing, the 24 patients could be assigned to three groups. In group 1 there were 4 patients HBV DNA‐negative before transplantation and none of these patients suffered recurrence of infection posttransplantation. In group 2, of 10 patients with pretransplantation infection with wild‐type virus, 7 became reinfected, and 1 of these developed HBV‐related graft failure. In group 3, 9 of 10 patients infected with precore mutant HBV strains became reinfected. However, in contrast to the patients in group 2, 7 patients in group 3 developed HBV‐related graft loss, and 5 of these patients had fibrosing cholestatic hepatitis (FCH). These results indicate that infection with precore mutant strains of HBV predisposes a patient to early graft loss following transplantation. (Hepatology 1995;21:14–18).