Liver transplantation-associated de novo hepatitis B virus infection: application of molecular evolutionary analysis.
OBJECTIVE
De novo hepatitis B virus (HBV) infection after liver transplantation has recently been reported to be associated with donors without serum hepatitis B surface antigen (HbsAg) but with hepatitis B core antigen (anti-HBc). We elucidate the source of de novo HBV infection after liver transplantation by molecular evolutionary analysis.


METHODS
The serum sample was obtained from a recipient who underwent living related liver transplantation. He was negative for all HBV-related serum markers before the transplantation. The recipient became seropositive for HBsAg at 6 months after transplantation. The liver tissue was obtained from a donor who was seronegative for HBsAg, but positive for anti-HBs and anti-HBc.


RESULTS
HBV DNA was detected from the serum and liver tissue in a recipient and donor, respectively. A total of 5 clones each of small-S gene of HBV from the donor and recipient were sequenced. A phylogenetic tree analysis based on small-S gene revealed that all isolates derived from the recipient and donor were clustered together within a close range of evolutionary distances. These results indicated that HBV was transmitted by the liver graft from the donor.


CONCLUSIONS
Molecular evolutionary analysis can be adopted for the study of the transmission route of viral infection via organ transplantation.
Sugauchi
Fuminaka
F
Second Department of Medicine, Nagoya City University Medical School, Nagoya, Japan.
Orito
Etsuro
E
Ohno
Tomoyoshi
T
Kato
Hideaki
H
Suzuki
Tatsuya
T
Hashimoto
Takashi
T
Manabe
Tadao
T
Ueda
Ryuzo
R
Mizokami
Masahi
M
D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000032:analysis / Q000097:blood; D019143:Evolution, Molecular; D006509:Hepatitis B / Q000635:transmission* / Q000821:virology*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008099:Liver / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D010802:Phylogeny; D016133:Polymerase Chain Reaction
D004279:DNA, Viral