The role of HBV genotype, core promoter and precore mutations in advanced liver disease in renal transplant recipients.
OBJECTIVE
In renal transplant recipients (RTRs), chronic hepatitis B virus (HBV) infection may lead to poor outcomes. This study aimed to investigate the role of the HBV genotype, core promoter and precore mutations in advanced liver disease in RTRs.


METHODS
We retrospectively reviewed 51 RTRs positive for hepatitis B surface antigen (HBsAg). HBV genotype determination and direct sequencing of core promoter and precore regions were performed using the baseline and end-of-follow-up sera post-renal transplantation.


RESULTS
Alanine Transaminase (ALT) and HBV DNA levels were elevated after transplantation (66%). HBV genotypes B and C were found in 45 (88%) and 6 (12%) patients, respectively. There was no significant association of cirrhosis development with ALT, and hepatitis B-e antigen (HBeAg) levels, type of immunosuppressant, HBV genotype, T1762/A1764 and A1896 mutations, and duration of follow-up, except endpoint HBV DNA levels (> or =10(5)copies/ml). High T1762/A1764 mutation rates were associated with high HBV DNA levels (P=0.036) at the endpoint.


CONCLUSIONS
HBV DNA replication was enhanced in RTRs with T1762/A1764 mutation. Increased serum HBV DNA levels were associated with cirrhosis development. T1762/A1764 mutation and cirrhosis development did not show significant correlation because of small sample size and/or interventional anti-viral therapies during follow-up.
Tsai
Ming-Chao
MC
Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
Chen
Chien-Hung
CH
Lee
Chuan-Mo
CM
Chen
Yen-Ta
YT
Chien
Yu-Shu
YS
Hung
Chao-Hung
CH
Wang
Jing-Houng
JH
Lu
Sheng-Nan
SN
Yen
Yi-Hao
YH
Changchien
Chi-Sin
CS
Hu
Tsung-Hui
TH
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006512:Hepatitis B Core Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000209:etiology* / Q000821:virology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011401:Promoter Regions, Genetic; D012189:Retrospective Studies
D004279:DNA, Viral; D006512:Hepatitis B Core Antigens; D007166:Immunosuppressive Agents; D000410:Alanine Transaminase