Serum hepatitis B virus DNA before liver transplantation correlates with HBV reinfection rate even under successful low-dose hepatitis B immunoglobulin prophylaxis

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• 作者：Tetsuya Yasunaka (1)
  Akinobu Takaki (1)
  Takahito Yagi (2)
  Yoshiaki Iwasaki (4)
  Hiroshi Sadamori (2)
  Kazuko Koike (1)
  Satoshi Hirohata (3)
  Masashi Tatsukawa (1)
  Daisuke Kawai (1)
  Hidenori Shiraha (1)
  Yasuhiro Miyake (1)
  Fusao Ikeda (1)
  Haruhiko Kobashi (1)
  Hiroaki Matsuda (2)
  Susumu Shinoura (2)
  Ryuichi Yoshida (2)
  Daisuke Satoh (2)
  Masashi Utsumi (2)
  Teppei Onishi (2)
  Kazuhide Yamamoto (1)
  
• 关键词：Hepatitis B virus ; Liver transplantation ; Recurrence ; HBcrAg ; HBV cccDNA
• 刊名：Hepatology International
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：5
• 期：4
• 页码：918-926
• 全文大小：375KB
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• 作者单位：Tetsuya Yasunaka (1)
  Akinobu Takaki (1)
  Takahito Yagi (2)
  Yoshiaki Iwasaki (4)
  Hiroshi Sadamori (2)
  Kazuko Koike (1)
  Satoshi Hirohata (3)
  Masashi Tatsukawa (1)
  Daisuke Kawai (1)
  Hidenori Shiraha (1)
  Yasuhiro Miyake (1)
  Fusao Ikeda (1)
  Haruhiko Kobashi (1)
  Hiroaki Matsuda (2)
  Susumu Shinoura (2)
  Ryuichi Yoshida (2)
  Daisuke Satoh (2)
  Masashi Utsumi (2)
  Teppei Onishi (2)
  Kazuhide Yamamoto (1)
  
  1. Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  2. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  4. Health Service Center, Okayama University, Okayama, Japan
  3. Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  

文摘

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.