title: Change of hepatitis B virus DNA status in anti-HBc positive liver graft.
abstract: OBJECTIVE
  Many patients with positive anti-HBc, but negative HBsAg, are known to harbor occult HBV infection, which may transmit the virus through the graft in liver transplantation. We examined the change of HBV DNA within the liver allograft tissue of the donor with positive anti-HBc, but negative HBsAg, before and after the transplantation and assessed its significance.
  
  
  METHODS
  Twenty-eight patients with available posttransplant biopsies that received anti-HBc positive liver allografts between April 2000 and November 2003 were enrolled in the study. Intraoperative wedge biopsy of donor liver and needle biopsy of the recipient around the 12th postoperative day were used. HBV DNA within the liver tissue was identified by polymerase chain reaction technique using paraffin-embedded liver tissue.
  
  
  RESULTS
  Among 13 patients that showed positive amplification before transplantation, 10 turned negative and 3 remained positive after transplantation. One patient, who was negative, became positive after transplantation. Three patients had recurrent HBV infection, but none had positive PCR before or after transplantation and recurrence was not associated with PCR results. Donors with low anti-HBs titer were more likely to be PCR positive compared to donors with high anti-HBs serology (P<0.05).
  
  
  CONCLUSIONS
  Under adequate prophylactic measures, the presence of HBV DNA within the liver tissue does not affect recurrence and most allografts harboring HBV DNA before transplantation will eventually show viral clearance. However, many anti-HBc positive allografts are infected by HBV at subclinical level so vigilant surveillance is essential.
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Choon Hyuck
authors.initials: CH
authors.lastname: Kwon
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Nam-Joon
authors.initials: NJ
authors.lastname: Yi
authors.forename: Ja-June
authors.initials: JJ
authors.lastname: Jang
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006510:Hepatitis B Antibodies / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000276:immunology / Q000821:virology; D006801:Humans; D008099:Liver / Q000821:virology; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged
chemical_list: D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens