title: Liver transplantation in delta virus infection.
abstract: Liver transplantation is the only therapy for patients with end-stage liver disease, hepatocellular carcinoma, or fulminant hepatitis due to hepatitis D virus (HDV) and hepatitis B virus (HBV) coinfection or superinfection. Patients chronically coinfected with HDV are less at risk of HBV recurrence and have a better survival rate than patients infected with HBV alone. Patients coinfected with HDV generally do not require pretransplant antiviral therapy. Rates of recurrent HBV-HDV infection are lower than 5% using low-dose intramuscular (IM) HBIg and antiviral prophylaxis in combination. Few studies have evaluated the possibility of using shorter-term HBIg (12-24 months) then switching to antiviral therapy. Although HBV replication can be controlled by potent HBV-polymerase inhibitors, reappearance of HBsAg and/or the persistence of HBV DNA in serum, liver, or peripheral blood mononuclear cells might have deleterious consequences in the setting of HBV-HDV coinfection as they may provide the biologic substrate to the reactivation of HDV. No effective antiviral drug is available for the treatment of graft infection with HDV.
authors.affiliation: Assistance Publique-Hopitaux de Paris, Hopital Paul Brousse, Centre Hepato-Biliaire, Villejuif, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Roche
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000821:virology; D060085:Coinfection / Q000150:complications; D058625:End Stage Liver Disease / Q000601:surgery* / Q000821:virology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000517:prevention & control; D006515:Hepatitis B virus / Q000276:immunology; D003699:Hepatitis D / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D019701:Hepatitis D, Chronic / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007116:Immunization, Passive; D008113:Liver Neoplasms / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation; D011182:Postoperative Care; D011300:Preoperative Care; D055502:Secondary Prevention; D015163:Superinfection / Q000150:complications
chemical_list: D000998:Antiviral Agents