Recurrence of hepatitis D (delta) in liver transplants: histopathological aspects.
BACKGROUND
The viral/pathological correlates of recurrent hepatitis delta virus (HDV) disease in orthotoptic liver transplants are reported.


METHODS
We examined the histological features of recurrent HDV disease in nine patients with transplants for terminal HDV cirrhosis were examined; intrahepatic HDV and hepatitis B virus (HBV) antigens were detected by immunoperoxidase techniques. Sera were tested for the battery of HDV and HBV markers.


RESULTS
In four patients, HDV reinfection was accompanied by the recurrence of an HBV infection with features of active viral replication. In the other five, HDV reinfection was accompanied by an atypical recurrence of HBV infection without evidence of active HBV replication (no expression of intrahepatic hepatitis B core antigen). In four of the latter patients, the atypical HBV pattern changed during the follow-up into a pattern of active viral replication accompanied by chronic necroinflammation detected during histology.


CONCLUSIONS
The pattern of recurrent HBV infection can influence the pathological aspects of the relapses of HDV disease in liver grafts.
David
E
E
Department of Biomedical Science and Human Oncology, University of Turin, Italy.
Rahier
J
J
Pucci
A
A
Camby
P
P
Scevens
M
M
Salizzoni
M
M
Otte
J B
JB
Galmarini
D
D
Marinucci
G
G
Ottobrelli
A
A
D000328:Adult; D001706:Biopsy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000302:isolation & purification; D003699:Hepatitis D / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D003698:Hepatitis Delta Virus / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008103:Liver Cirrhosis / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D007074:Immunoglobulin G; D007075:Immunoglobulin M