De novo hepatitis B virus infection developing after liver transplantation using a graft positive for hepatitis B core antibody

• Published in: Annals of surgical treatment and research Vol. 89; no. 3; pp. 145 - 150
• Main Authors: Han, Jae Hyun, Kim, Dong Goo, Na, Gun Hyung, Kim, Eun Young, Lee, Soo Ho, Hong, Tae Ho, You, Young Kyoung, Choi, Jong Young, Yoon, Seung Kew
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한외과학회 01.09.2015; The Korean Surgical Society
• Subjects: Original; 일반외과학; Hepatitis B antibodies; Prognosis; de novo hepatitis B; Liver transplantation
• ISSN: 2288-6575; 2288-6796
• DOI: 10.4174/astr.2015.89.3.145

The use of hepatitis B core antibody (HBcAb)-positive grafts is increasing, especially where hepatitis B is endemic. However, this remains controversial because of the risk of development of de novo HBV infection. We collected information obtained between January 2000 and December 2012 and retrospectively analyzed data on 187 HBsAg-negative donors and recipients were analyzed retrospectively. De novo HBV infection was defined as development of HBsAg positivity with or without detection of HBV DNA. Forty patients (21.4%) received HBcAb-positive grafts. Survival rate did not differ by donor HBcAb status (P = 0.466). De novo HBV infection occurred in five patients (12.5%) who were not treated with anti-HBV prophylaxis, and was significantly more prevalent in hepatitis B surface antibody (HBsAb)- and HBcAb-negative than HBsAb- and HBcAb-positive recipients (50% vs. 4.2%, P = 0.049). All patients except one were treated with entecavir with/without antihepatitis B immunoglobulin and four were negative in terms of HBV DNA seroconversion. No patient died. HBcAb-positive grafts are safe without survival difference. However, the risk of de novo hepatitis B virus infection was significantly increased in HBsAb- and HBcAb-negative recipients. All patients were successfully treated even after recurrence.