title: De novo hepatitis B virus infection from anti-HBc-positive donors in pediatric living donor liver transplantation.
abstract: OBJECTIVE
  The aim of this study was to analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from hepatitis B core antibody (anti-HBc)-positive donors in pediatric living donor liver transplantation (LDLT).
  
  
  METHODS
  We retrospectively analyzed 46 recipients without pre-liver transplantation (LT) HBV infection evidence who underwent LDLT from October 2006 to May 2011 in our center. HBV markers, including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs), anti-HBc, hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT. HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.
  
  
  RESULTS
  Without prophylaxis, de novo HBV infection occurred in 11 of 46 recipients (23.9%) 6-36 months after LT. All 11 patients received grafts from anti-HBc-positive donors. The donors' baseline status and the characteristics of recipients at the time of transplantation were not associated with the acquisition of de novo hepatitis B infection. The overall 2-year survival rate of patients from anti-HBc-positive donors was 84.2%. Two de novo HBV-infected patients who had YMDD mutation were given adefovir combined with lamivudine, and their liver function gradually improved during the follow-up period.
  
  
  CONCLUSIONS
  Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients. Administration with adefovir in patients who are resistant to lamivudine seems to be an effective and safe way for de novo HBV infection.
authors: Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Zhi Feng
authors: ZF
authors: Xi
authors: Qiang
authors: Q
authors: Xia
authors: Jian Jun
authors: JJ
authors: Zhang
authors: Xiao Song
authors: XS
authors: Chen
authors: Long Zhi
authors: LZ
authors: Han
authors: Jian Jun
authors: JJ
authors: Zhu
authors: Si Yue
authors: SY
authors: Wang
authors: De Kai
authors: DK
authors: Qiu
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D006512:Hepatitis B Core Antigens / Q000097:blood*; D017325:Hepatitis B Vaccines; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D017325:Hepatitis B Vaccines
keywords: de novo hepatitis B infection; hepatitis B core antibody; pediatric living donor liver transplantation