Solid-organ transplantation in HBsAg-negative patients with antibodies to HBV core antigen: low risk of HBV reactivation.
Hepatitis B virus (HBV) reactivation is a well-described event in HBV surface antigen (HbsAg)-positive patients undergoing immunosuppression. There are only few data about the risk of HBV reactivation in HBsAg-negative solid-organ transplant recipients with resolved HBV infection. We conducted a systematic screening of serum and liver samples from 38 HBsAg-negative and anti-HBV core antigen (anti-HBc)-positive patients for the presence of HBV-DNA and for serologic HBV markers before and after solid-organ transplantation (kidney, n=23; liver, n=9; heart, n=6). Pretransplant prevalence of HBV-DNA was 24% (6/25) in serum and 33% (3/9) in liver samples. Forty-four percent (15/34) of the recipients were viremic after transplantation; this finding was more common in patients coinfected with hepatitis C (P=0.011) and in patients negative for anti-HBs (P=0.001). Two recipients became antigenemic (HBsAg-positive), but none developed clinical signs of hepatitis. In conclusion, subclinical reactivation of HBV infection was detected in a significant proportion of HBsAg-negative solid-organ-transplant recipients.
Knöll
Antje
A
Institute of Medical Microbiology and Hygiene, University of Regensburg, D-93042 Regensburg, Germany. antje.knoell@klinik.uni-regensburg.de
Pietrzyk
Miriam
M
Loss
Martin
M
Goetz
Wolfgang A
WA
Jilg
Wolfgang
W
D000914:Antibodies, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
D000914:Antibodies, Viral; D006514:Hepatitis B Surface Antigens