title: Variability of the Hepatitis B Surface Protein in HBV-Infected Liver Transplant Recipients.
abstract: Variations in the major surface proteins (HBsAg) of hepatitis B virus (HBV) have been implicated in the high rate of reinfection in HBV-infected recipients of orthotopic liver transplantations (OLT). Sera from 6 OLT patients positive for HBsAg and from 3 recipients negative for it prior to transplantation were analyzed over several years, and 39 HBsAg sequences were compared. Despite anti-HBs immunoprophylaxis resulting in the disappearance of HBsAg, HBV DNA was detectable by a sensitive nested PCR in almost all sera. In 1 patient, a significant temporary shift in HBV subtypes was observed, indicating a mixed infection or the presence of multiple HBV populations in this patient; this was also true for other patients. Amino acid substitutions compared to wild-type HBV subtypes in 7 patients and variations within patients in 5 patients were detectable over time; the 'escape mutation' at amino acid position 145 was detected in 2 patients. Our data suggest that the high rate of reinfection in OLT recipients seems not to be associated with specific sequence variations in the major HBs gene, but shows a remarkable inter- and intraindividual variability. Obviously, no correlation between heterogeneity in this gene and clinical outcome was present. Copyright 1997 S. Karger AG, Basel
authors.affiliation: Max von Pettenkofer Institute of Medical Virology, Klinikum Grosshadern, University of Munich, Germany.
authors.forename: H.M.
authors.initials: HM
authors.lastname: Schätzl
authors.forename: E.
authors.initials: E
authors.lastname: Sieger
authors.forename: W.
authors.initials: W
authors.lastname: Jilg
authors.forename: H.
authors.initials: H
authors.lastname: Nitschko
authors.forename: R.
authors.initials: R
authors.lastname: Zachoval