title: Hepatitis B virus genotype A and D and clinical outcomes of liver transplantation for HBV-related disease.
abstract: Hepatitis B virus (HBV) genotypes have been associated with specific patterns of disease and response to antiviral therapy. We investigated the effect of HBV genotype on HBV recurrence and mortality after liver transplantation (LT). Pretransplant sera of 45 hepatitis B surface antigen (HBsAg) positive adults were submitted for HBV genotyping by a reverse-phase hybridization line probe assay with genotype-specific probes. Data were correlated with clinical outcomes after transplantation. Genotype A (n =15), D (n = 13) and A/D (n = 12) accounted for 89% of all genotypes. Coinfection with two HBV genotypes was encountered in 14 (31.1%) patients. Eighteen patients (40 %) developed HBV recurrence at a median of 10 months posttransplant (range, 1-53) and 10 patients (22 %) died at a median of 24 months (range, 3-63). Genotype D patients were more likely to develop HBV recurrence or die compared with genotype A patients, although this did not reach statistical significance. Dual infection with genotype A/D resulted in mortality similar to that of genotype A but recurrence similar to that of genotype D. Active viral replication at time of transplantation was the only independent factor (P = 0.03) that predicted HBV recurrence. In conclusion, HBV genotype A and D did not have a significant impact on clinical outcomes of LT for HBV-related liver disease in patients of European origin. These data do not support routine HBV genotyping in liver transplantation.
authors.affiliation: Institute of Liver Studies, King's College Hospital, Denmark Hill, London.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Girlanda
authors.forename: Abdul H
authors.initials: AH
authors.lastname: Mohsen
authors.forename: Heather
authors.initials: H
authors.lastname: Smith
authors.forename: Erwin
authors.initials: E
authors.lastname: Sablon
authors.forename: Man-Fung
authors.initials: MF
authors.lastname: Yuen
authors.forename: John
authors.initials: J
authors.lastname: O'Grady
authors.forename: Paolo
authors.initials: P
authors.lastname: Muiesan
authors.forename: Mohamed
authors.initials: M
authors.lastname: Rela
authors.forename: Nigel
authors.initials: N
authors.lastname: Heaton
authors.forename: Suzanne
authors.initials: S
authors.lastname: Norris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D006085:Graft Survival; D006509:Hepatitis B / Q000601:surgery*; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014779:Virus Replication