Change of hepatitis B virus DNA status in anti-HBc positive liver graft.
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.
Kwon
Choon Hyuck
CH
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Suh
Kyung-Suk
KS
Cho
Jai Young
JY
Yi
Nam-Joon
NJ
Jang
Ja-June
JJ
Lee
Kuhn Uk
KU
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
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens