Serum Hepatitis B Virus DNA Before Liver Transplantation Correlates with HBV Reinfection Rate Even Under Successful Low-dose Hepatitis B Immunoglobulin Prophylaxis

Overview

Journal Hepatol Int

Publisher Springer

Specialty Gastroenterology

Date 2011 Apr 13

PMID 21484119

Citations 15

Authors

Tetsuya Yasunaka

Akinobu Takaki

Takahito Yagi

Yoshiaki Iwasaki

Hiroshi Sadamori

Kazuko Koike

Satoshi Hirohata

Masashi Tatsukawa

Daisuke Kawai

Hidenori Shiraha

Yasuhiro Miyake

Fusao Ikeda

Haruhiko Kobashi

Hiroaki Matsuda

Susumu Shinoura

Ryuichi Yoshida

Daisuke Satoh

Masashi Utsumi

Teppei Onishi

Kazuhide Yamamoto

Affiliations

Soon will be listed here.

Abstract

Purpose: The combination of hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogues has been accepted as the best treatment to control hepatitis B recurrence after orthotopic liver transplantation (OLT). However, the optimal dose of HBIg remains unclear. We have previously reported that high-dose HBIg in the early period followed by low-dose HBIg with nucleos(t)ide analogues offers reliable and cost-effective control of hepatitis B recurrence. The aim of this study was to investigate intrahepatic hepatitis B virus (HBV) reinfection status with our clinically successful protocol.

Methods: We quantified levels of intrahepatic HBV covalently closed circular (ccc) deoxyribonucleic acid (DNA) and serum hepatitis B core-related antigen (HBcrAg), a new serological marker that can estimate intrahepatic cccDNA levels. Nucleos(t)ide analogues were administered in all cases.

Results: No patients showed recurrence of hepatitis B surface antigen (HBsAg) or HBV-DNA. However, HBV, cccDNA, and HBcrAg were positive in 57% and 48% of patients after OLT, respectively. Pre-OLT serum HBV-DNA and HBcrAg levels correlated linearly with post-OLT cccDNA levels ( = 0.534, < 0.05, and = 0.634, < 0.05, respectively). High serum HBV-DNA and HBcrAg levels, particularly with >3 log copies/mL and >4 log IU/mL, respectively, at the time of OLT, were associated with high levels of post-OLT cccDNA. Even with our successful protocol, nearly half of patients showed HBV reinfection.

Conclusions: Patients with high serum HBV-DNA and HBcrAg levels before OLT (particularly >3 log copies/mL and >4 log IU/mL, respectively) should be followed with care for HBV recurrence.

Citing Articles

Early intrahepatic recurrence of HBV infection in liver transplant recipients despite antiviral prophylaxis.

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PMID: 37122357 PMC: 10131114. DOI: 10.1016/j.jhepr.2023.100728.

Hepatitis B Core-Related Antigen and New Therapies for Hepatitis B.

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Novel biomarkers for the management of chronic hepatitis B.

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The Role of Hepatitis B Core-Related Antigen.

Inoue T, Tanaka Y Genes (Basel). 2019; 10(5).

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The relationship between HBcrAg and HBV reinfection in HBV related post-liver transplantation patients.

Urabe A, Imamura M, Tsuge M, Kan H, Fujino H, Fukuhara T J Gastroenterol. 2016; 52(3):366-375.

PMID: 27422771 DOI: 10.1007/s00535-016-1240-y.

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