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Severe clinical course of de novo hepatitis B infection after liver transplantation
Author(s) -
Crespo Javier,
Fábrega Emilio,
Casafont Fernando,
Rivero Monserrat,
de las Heras Gonzalo,
de la Peña Joaquín,
de la Cruz Fernando,
PonsRomero Fernando
Publication year - 1999
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500050301
Subject(s) - hbsag , medicine , fulminant hepatitis , liver transplantation , hepatitis b virus , hepatitis b , virology , liver disease , hepatitis , immunology , transplantation , fulminant , virus
The aim of this study is to determine the origin, clinical outcome, allograft histological characteristics, and virological outcome of de novo hepatitis B virus (HBV) infection after orthotopic liver transplantation (OLT). We studied 136 hepatitis B surface antigen (HBsAg)‐negative liver transplant recipients. HBV DNA was detected by dot‐blot hybridization and polymerase chain reaction (PCR). The S gene was sequenced. Hepatitis C virus (HCV) RNA was assessed by PCR. The long‐term clinical and histological outcome was determined. Six of 136 HBsAg‐negative patients (4.4%) became HBsAg positive after transplantation. The source of HBV infection was reactivation of latent HBV infection in 2 patients and was not identified in 4 patients. Two donors had isolated core antibody. Two of these 6 patients developed acute liver failure related to hepatitis B. The 4 other patients had severe chronic hepatitis related to hepatitis B. All patients had high‐level HBV replication. No significant mutations in the S gene were found. These data suggest that de novo hepatitis B infection is not a mild disease and might represent a significant cause of graft dysfunction. This is the first report of fulminant hepatitis caused by de novo hepatitis B infection after OLT.