Fibrosing cholestatic hepatitis in a renal transplant recipient associated with the hepatitis B virus precore mutant.
A patient with evidence of chronic infection with hepatitis B virus (seropositive for hepatitis B surface antigen, and with antibody to hepatitis B e antigen) underwent renal transplantation, which subsequently failed. The patient developed abnormal liver function tests and 8 months after the removal of the transplanted kidney, hepatitis B virus DNA was detected in the serum in the absence of hepatitis B e antigen. Liver biopsy revealed the presence of fibrosing cholestatic hepatitis. Sequence analysis of the serum hepatitis B virus DNA showed the presence of the pre-core mutant. This case shows that fibrosing cholestatic hepatitis can occur outside the setting of liver transplantation, and coincided with the development of the pre-core mutant of hepatitis B virus.
Booth
J C
JC
Academic Department of Medicine, St. Mary's Hospital Medical School, London, UK.
Goldin
R D
RD
Brown
J L
JL
Karayiannis
P
P
Thomas
H C
HC
D001483:Base Sequence; D002779:Cholestasis / Q000276:immunology / Q000473:pathology*; D004279:DNA, Viral / Q000032:analysis; D005355:Fibrosis; D006084:Graft Rejection; D006505:Hepatitis / Q000276:immunology / Q000473:pathology*; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015335:Molecular Probes / Q000235:genetics; D008969:Molecular Sequence Data; D009154:Mutation; D011183:Postoperative Complications
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D015335:Molecular Probes