De Novo Hepatitis B Infection From Hepatitis B Core Antibody-Positive Donors During Hepatitis B Immunoglobulin Prophylaxis.
De novo hepatitis B infection in patients receiving liver transplants from hepatitis B core antibody-positive donors is well known, but the effective prevention strategy has not been well established. In our hospital, recipients receive hepatitis B immunoglobulin monotherapy if they are hepatitis B surface antigen negative at the time of transplant and are receiving a liver from a hepatitis B core antibody-positive donor. Since August 2006, we have had 4 patients who were naïve to hepatitis B virus and received a hepatitis B core antibody-positive graft. Two patients died of other causes, and 2 patients, who had liver transplant in October 2006 and October 2009, developed de novo hepatitis B. Both patients were tested annually for serum hepatitis B surface antigen as part of routine visit. Tests were negative; however, both patients recently became hepatitis B surface antigen positive. Other laboratory results, including liver function test, were unremarkable, except HBsAb titer was undetectable even though hepatitis B immunoglobulin monotherapy had been administrated 2 months previously in both patients. The patients had hepatitis B virus DNA levels of 3.07E+08 copies/mL and 1.51E+08 copies/mL. We suggest that additional prophylactic therapies above hepatitis B immunoglobulin monotherapy are needed for these recipients.
From the Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
Milljae
M
Shin
Seong-Hwan
SH
Chang
D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D004279:DNA, Viral / Q000235:genetics; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome; D019562:Viral Load
D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin