title: Hepatitis B virus reactivation after kidney transplantation and new onset lymphoma.
abstract: A case of hepatitis B virus (HBV) reactivation after kidney transplantation is reported. The presence of antibodies against hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg) before transplantation indicated previous infection with HBV. Eight years after transplantation, a diffuse, large B-cell lymphoma occurred, and the patient was positive for HBsAg and hepatitis B e antigen, in association with normal activity of serum aminotransferases. Postmortem liver histology did not show any sign of portal tract or lobular inflammation despite the presence at immunostaining of extensive intranuclear and cytoplasmic positivity for HBcAg, indicating active viral replication. Natural immunity to HBV may not protect against reactivation in patients with a suppressed immune system. In this setting, periodic follow-up of HBV serology in patients at highest risk for HBV reactivation to allow for early diagnosis and prompt treatment with lamivudine is highly recommended.
authors.affiliation: Department of Medicine, College of Physicians and Seurgeons, Columbia University, New York, New York 10032, USA. al2021@csolumbia.edu
authors.forename: Alberto
authors.initials: A
authors.lastname: Larghi
authors.forename: Daniel
authors.initials: D
authors.lastname: Leffler
authors.forename: Harold
authors.initials: H
authors.lastname: Frucht
authors.forename: Moshe
authors.initials: M
authors.lastname: Rubin
authors.forename: Carol E
authors.initials: CE
authors.lastname: Semrad
authors.forename: Jay H
authors.initials: JH
authors.lastname: Lefkowitch
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Worman
mesh_terms: D000368:Aged; D015897:Comorbidity; D017809:Fatal Outcome; D006509:Hepatitis B / Q000453:epidemiology / Q000276:immunology*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology*; D008099:Liver / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D014775:Virus Activation