title: De novo and apparent de novo hepatitis B virus infection after liver transplantation.
abstract: OBJECTIVE
  The aim of this study was to clarify the aetiology of apparent de novo HBV infection after liver transplantation.
  
  
  METHODS
  Twenty out of 570 HBsAg negative patients (3.5%) became HBsAg positive after transplantation and were studied. Donor and recipient sera were retrospectively tested for HBsAg, anti-HBs, anti-HBc, and HBV DNA by PCR. Donor and recipient livers were tested for HBV DNA by PCR on paraffin-embedded tissue.
  
  
  RESULTS
  Group 1: HBV infection of donor origin (eight patients): one donor serum was HBsAg positive, three were serum HBV DNA positive, four were liver HBV DNA positive. Group 2: reactivation of latent HBV infection (eight patients) with detection of HBV DNA in pretransplant serum (seven patients) or in native liver (one patient): three were anti-HBs positive, two anti-HBc positive, and three with fulminant hepatitis had no serological HBV markers. Group 3: undetermined origin (four patients) defined by absence of HBV DNA in pretransplant donor and/or recipient sera and liver; however, acquired infection was suspected from two anti-HBs and anti-HBc positive donors. Two patients became HBsAg negative, and five HBV DNA negative. One died from HBV-cirrhosis and two were retransplanted. In the others, the last histology showed cirrhosis (three), chronic hepatitis (nine), acute hepatitis (one), and non-specific change (four patients).
  
  
  CONCLUSIONS
  The prevalence of de novo HBV infection in liver transplant patients was 3.5%; the aetiology was determined in 16/20 patients: from the donor in eight, and from the recipient in eight. One should be cautious when donors or recipients are anti-HBc or both anti-HBs and anti-HBc positive.
authors.affiliation: Centre Hépato-Biliaire, Faculté de Médecine, Université Paris Sud, France.
authors.forename: B
authors.initials: B
authors.lastname: Roche
authors.forename: D
authors.initials: D
authors.lastname: Samuel
authors.forename: M
authors.initials: M
authors.lastname: Gigou
authors.forename: C
authors.initials: C
authors.lastname: Feray
authors.forename: V
authors.initials: V
authors.lastname: Virot
authors.forename: L
authors.initials: L
authors.lastname: Schmets
authors.forename: M F
authors.initials: MF
authors.lastname: David
authors.forename: J L
authors.initials: JL
authors.lastname: Arulnaden
authors.forename: A
authors.initials: A
authors.lastname: Bismuth
authors.forename: M
authors.initials: M
authors.lastname: Reynes
authors.forename: H
authors.initials: H
authors.lastname: Bismuth
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology / Q000628:therapy; D006509:Hepatitis B / Q000453:epidemiology / Q000209:etiology* / Q000635:transmission; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D006801:Humans; D007150:Immunohistochemistry; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D014184:Transplantation, Homologous / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens