Clinical Course of Hepatitis B Virus Infection in Renal Allograft Recipients

• Published in: Digestive diseases and sciences 2007-12, Vol.52 (12), p.3440-3443
• Main Authors: SAVAS, Nurten, COLAK, Turan, SELCUK, Haldun, YILMAZ, Ugur, HABERAL, Mehmet
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Biological and medical sciences; Biopsy; DNA, Viral - genetics; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Hepatitis B; Hepatitis B e Antigens - immunology; Hepatitis B Surface Antigens - immunology; Hepatitis B virus; Hepatitis B virus - genetics; Hepatitis B virus - immunology; Hepatitis B virus - physiology; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - pathology; Hepatitis B, Chronic - virology; Human viral diseases; Humans; Infectious diseases; Kidney Transplantation; Lamivudine - therapeutic use; Liver - pathology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Polymerase Chain Reaction; Retrospective Studies; Reverse Transcriptase Inhibitors - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Treatment Outcome; Viral diseases; Viral hepatitis; Virus Activation
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-006-9714-z

The outcome of renal transplantation is adversely affected by hepatitis B virus infection. We retrospectively analyzed data of 1,251 renal transplant recipients, 20 of whom were hepatitis B surface antigen positive and hepatitis B virus DNA negative at the time of renal transplantation. Hepatitis B virus reactivation was seen in 14 of the 20 patients at a mean time of 16.3+/-7.1 months after transplantation. All patients with hepatitis B virus reactivation after transplantation were treated with lamivudine, biochemical, and serologic response was achieved in 13 of 14 patients at a mean time of 7.0+/-1.1 months. Seven of 13 patients experienced a breakthrough at a mean time of 9.2+/-6.2 months. Three of the 20 patients died at a mean time of 57.0+/-38.5 months after transplantation. Our data demonstrated that chronic immunosuppression is associated with a significantly high risk of hepatitis B virus reactivation in renal transplant recipients and hepatitis B reactivation does not increase the likelihood of graft rejection or patient mortality after renal transplantation.