Journal of Gastroenterology
March 2017, Volume 52, Issue 3, pp 366–375
The relationship between HBcrAg and HBV reinfection in HBV related post-liver transplantation patients
- Ayako Urabe
- Michio Imamura
- Masataka Tsuge
- Hiromi Kan
- Hatsue Fujino
- Takayuki Fukuhara
- Keiichi Masaki
- Tomoki Kobayashi
- Atsushi Ono
- Takashi Nakahara
- Tomokazu Kawaoka
- Akira Hiramatsu
- Yoshiiku Kawakami
- Hiroshi Aikata
- Clair Nelson Hayes
- Ayako Urabe
- Michio Imamura
- Masataka Tsuge
- Hiromi Kan
- Hatsue Fujino
- Takayuki Fukuhara
- Keiichi Masaki
- Tomoki Kobayashi
- Atsushi Ono
- Takashi Nakahara
- Tomokazu Kawaoka
- Akira Hiramatsu
- Yoshiiku Kawakami
- Hiroshi Aikata
- Clair Nelson Hayes
- Noboru Maki
- Hideaki Ohdan
- Kazuaki Chayama
Email author
- 1.Department of Gastroenterology and Metabolism, Applied Life ScienceInstitute of Biomedical and Health Science, Hiroshima University, Hiroshima UniversityHiroshimaJapan
- 2.Advanced Life Science Institute, Inc.WakoJapan
- 3.Division of Frontier Medical Science, Department of Surgery, Programs for Biomedical ResearchGraduate School of Biomedical Science, Hiroshima UniversityHiroshimaJapan
Original Article—Liver, Pancreas, and Biliary TractFirst Online: 15 July 2016
DOI: 10.1007/s00535-016-1240-y
Cite this article as: Urabe, A., Imamura, M., Tsuge, M. et al. J Gastroenterol (2017) 52: 366. doi:10.1007/s00535-016-1240-y
AbstractBackgroundPost-transplant hepatitis B virus (HBV) reinfection is one of the major problems facing patients who undergo HBV-related liver transplantation (LT). We analyzed the clinical impact of serum hepatitis B core-related antigen (HBcrAg) on HBV reinfection in post-LT patients with HBV-related liver diseases.
MethodsSerum hepatitis B surface antigen (HBsAg), HBV DNA, and HBcrAg were measured over time in 32 post-LT patients. Twenty-one out of 32 patients had HCC at LT. The effects of HBcrAg, hepatocellular carcinoma (HCC) recurrence, and HBs gene mutation on HBV reinfection and withdrawal from hepatitis B immune globulin (HBIG) were analyzed.
ResultsSixteen out of 32 patients (50 %) were positive for HBcrAg even though only six patients were thought to have experienced HBV reinfection based on reappearance of either HBV DNA or HBsAg during a median follow-up time of 75 months. Three of these six patients who became re-infected with HBV experienced HCC recurrence after LT. The HBV DNA reappearance rate was significantly higher in patients with HCC recurrence after LT (p < 0.001). Two HBV re-infected patients without HCC recurrence had HBs gene mutations G145R and G145A, respectively. Anti-HBs antibody development rate by HB vaccination was similar between HBcrAg-positive and negative patients (p = 0.325).
ConclusionsHBV reinfection is more common than is usually considered based on conventional measurement of HBsAg and HBV DNA. HCC recurrence and mutations in the HBV S gene were associated with HBV reinfection after LT.
KeywordsLiver transplantationHBV reinfectionHBcrAgHBs gene mutationsHepatitis B immune globulin
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