TY - JOUR
T1 - Serum hepatitis B virus DNA before liver transplantation correlates with HBV reinfection rate even under successful low-dose hepatitis B immunoglobulin prophylaxis
AU - Yasunaka, Tetsuya
AU - Takaki, Akinobu
AU - Yagi, Takahito
AU - Iwasaki, Yoshiaki
AU - Sadamori, Hiroshi
AU - Koike, Kazuko
AU - Hirohata, Satoshi
AU - Tatsukawa, Masashi
AU - Kawai, Daisuke
AU - Shiraha, Hidenori
AU - Miyake, Yasuhiro
AU - Ikeda, Fusao
AU - Kobashi, Haruhiko
AU - Matsuda, Hiroaki
AU - Shinoura, Susumu
AU - Yoshida, Ryuichi
AU - Satoh, Daisuke
AU - Utsumi, Masashi
AU - Onishi, Teppei
AU - Yamamoto, Kazuhide
PY - 2011/12
Y1 - 2011/12
N2 - Purpose: The combination of hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogues has been accepted as the best treatment to control hepatitis B recurrence after orthotopic liver transplantation (OLT). However, the optimal dose of HBIg remains unclear. We have previously reported that high-dose HBIg in the early period followed by low-dose HBIg with nucleos(t)ide analogues offers reliable and cost-effective control of hepatitis B recurrence. The aim of this study was to investigate intrahepatic hepatitis B virus (HBV) reinfection status with our clinically successful protocol. Methods: We quantified levels of intrahepatic HBV covalently closed circular (ccc) deoxyribonucleic acid (DNA) and serum hepatitis B core-related antigen (HBcrAg), a new serological marker that can estimate intrahepatic cccDNA levels. Nucleos(t)ide analogues were administered in all cases. Results: No patients showed recurrence of hepatitis B surface antigen (HBsAg) or HBV-DNA. However, HBV, cccDNA, and HBcrAg were positive in 57% and 48% of patients after OLT, respectively. Pre-OLT serum HBV-DNA and HBcrAg levels correlated linearly with post-OLT cccDNA levels (r = 0.534, P < 0.05, and r = 0.634, P < 0.05, respectively). High serum HBV-DNA and HBcrAg levels, particularly with >3 log10 copies/mL and >4 log10 IU/mL, respectively, at the time of OLT, were associated with high levels of post-OLT cccDNA. Even with our successful protocol, nearly half of patients showed HBV reinfection. Conclusions: Patients with high serum HBV-DNA and HBcrAg levels before OLT (particularly >3 log10 copies/mL and >4 log10 IU/mL, respectively) should be followed with care for HBV recurrence.
AB - Purpose: The combination of hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogues has been accepted as the best treatment to control hepatitis B recurrence after orthotopic liver transplantation (OLT). However, the optimal dose of HBIg remains unclear. We have previously reported that high-dose HBIg in the early period followed by low-dose HBIg with nucleos(t)ide analogues offers reliable and cost-effective control of hepatitis B recurrence. The aim of this study was to investigate intrahepatic hepatitis B virus (HBV) reinfection status with our clinically successful protocol. Methods: We quantified levels of intrahepatic HBV covalently closed circular (ccc) deoxyribonucleic acid (DNA) and serum hepatitis B core-related antigen (HBcrAg), a new serological marker that can estimate intrahepatic cccDNA levels. Nucleos(t)ide analogues were administered in all cases. Results: No patients showed recurrence of hepatitis B surface antigen (HBsAg) or HBV-DNA. However, HBV, cccDNA, and HBcrAg were positive in 57% and 48% of patients after OLT, respectively. Pre-OLT serum HBV-DNA and HBcrAg levels correlated linearly with post-OLT cccDNA levels (r = 0.534, P < 0.05, and r = 0.634, P < 0.05, respectively). High serum HBV-DNA and HBcrAg levels, particularly with >3 log10 copies/mL and >4 log10 IU/mL, respectively, at the time of OLT, were associated with high levels of post-OLT cccDNA. Even with our successful protocol, nearly half of patients showed HBV reinfection. Conclusions: Patients with high serum HBV-DNA and HBcrAg levels before OLT (particularly >3 log10 copies/mL and >4 log10 IU/mL, respectively) should be followed with care for HBV recurrence.
KW - HBV cccDNA
KW - HBcrAg
KW - Hepatitis B virus
KW - Liver transplantation
KW - Recurrence
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U2 - 10.1007/s12072-011-9265-z
DO - 10.1007/s12072-011-9265-z
M3 - Article
AN - SCOPUS:81855185266
SN - 1936-0533
VL - 5
SP - 918
EP - 926
JO - Hepatology International
JF - Hepatology International
IS - 4
ER -
