Prevalence and clinical significance of occult hepatitis B virus infection among renal transplant recipients in Korea.
BACKGROUND
Occult hepatitis B infection (OBI) is the presence of hepatitis B virus (HBV) DNA in serum or hepatic tissue without detectable hepatitis B surface antigen (HBsAg) in serum. Kidney disease patients in the post-renal transplantation period are in a specific situation as a result of the high pre-transplantational risk of HBV infection and post-transplantational immunosuppression. We studied the pre-transplantational prevalence and post-transplantational influence of OBI on kidney transplantation patients.


METHODS
We investigated pre-transplantational serum samples of 217 HBsAg-negative patients of post-renal transplant status for the presence of HBV DNA by real-time quantitative polymerase chain reaction. Serologic markers for HBV and hepatitis C virus (HCV) infection as well as liver enzymes were analyzed.


RESULTS
We detected HBV DNA in 2.3% (5/217) of HBsAg-negative patients, and the median HBV DNA titer was 33.15 copies/ml (range 30.6-144.6 copies/ml). Among the 5 OBI patients, 2 had hepatitis B surface antibodies (anti-HBs) and 1 had hepatitis B core antibodies (anti-HBc IgG). None of the patients with OBI were co-infected with HCV. There was no evidence of reactivation of OBI during the 36-month (range 27-63 months) follow-up monitoring period after transplantation, in spite of immune suppression to prevent rejection.


CONCLUSIONS
The prevalence of occult HBV in the setting of renal transplantation was higher than that in the general population of Korea, and no reactivation of hepatitis B was observed in patients with OBI in the post-renal transplantation period.
Department of Laboratory Medicine, Central Veterans Hospital, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, Korea.
Eunsin
E
Bae
Chang-Hun
CH
Park
Chang-Seok
CS
Ki
Sung-Joo
SJ
Kim
Wooseong
W
Huh
Ha-Young
HY
Oh
Eun-Suk
ES
Kang
D000328:Adult; D004279:DNA, Viral / Q000097:blood / Q000302:isolation & purification; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology* / Q000821:virology; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D016030:Kidney Transplantation; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D056910:Republic of Korea; D012189:Retrospective Studies; D014180:Transplantation
D004279:DNA, Viral