The Relationship Between HBcrAg and HBV Reinfection in HBV Related Post-liver Transplantation Patients

Overview

Journal J Gastroenterol

Specialty Gastroenterology

Date 2016 Jul 17

PMID 27422771

Citations 8

Authors

Ayako Urabe

Michio Imamura

Masataka Tsuge

Hiromi Kan

Hatsue Fujino

Takayuki Fukuhara

Keiichi Masaki

Tomoki Kobayashi

Atsushi Ono

Takashi Nakahara

Tomokazu Kawaoka

Akira Hiramatsu

Yoshiiku Kawakami

Hiroshi Aikata

Clair Nelson Hayes

Noboru Maki

Hideaki Ohdan

Kazuaki Chayama

Affiliations

Soon will be listed here.

Abstract

Background: Post-transplant hepatitis B virus (HBV) reinfection is one of the major problems facing patients who undergo HBV-related liver transplantation (LT). We analyzed the clinical impact of serum hepatitis B core-related antigen (HBcrAg) on HBV reinfection in post-LT patients with HBV-related liver diseases.

Methods: Serum hepatitis B surface antigen (HBsAg), HBV DNA, and HBcrAg were measured over time in 32 post-LT patients. Twenty-one out of 32 patients had HCC at LT. The effects of HBcrAg, hepatocellular carcinoma (HCC) recurrence, and HBs gene mutation on HBV reinfection and withdrawal from hepatitis B immune globulin (HBIG) were analyzed.

Results: Sixteen out of 32 patients (50 %) were positive for HBcrAg even though only six patients were thought to have experienced HBV reinfection based on reappearance of either HBV DNA or HBsAg during a median follow-up time of 75 months. Three of these six patients who became re-infected with HBV experienced HCC recurrence after LT. The HBV DNA reappearance rate was significantly higher in patients with HCC recurrence after LT (p < 0.001). Two HBV re-infected patients without HCC recurrence had HBs gene mutations G145R and G145A, respectively. Anti-HBs antibody development rate by HB vaccination was similar between HBcrAg-positive and negative patients (p = 0.325).

Conclusions: HBV reinfection is more common than is usually considered based on conventional measurement of HBsAg and HBV DNA. HCC recurrence and mutations in the HBV S gene were associated with HBV reinfection after LT.

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