De novo hepatitis b virus infection after liver transplantation

Abstract

De novo hepatitis B virus (HBV) infection developing after liver transplantation (LTx) is the development of infection in a patient with liver disease etiologically unrelated to HBV infection and who had no preoperative HBV markers.Objective: to analyze the clinical features and characteristics of de novo HBV infection and evaluate the efficacy of nucleos(t)ide analogue therapy in liver transplant recipients.Materials and methods. The study involved 247 adult patients who underwent deceased donor LTx from 2016 to 2022 at Shumakov National Medical Research Center of Transplantology and Artificial Organs and who had no pre-transplant HBV markers.Results. Twenty-two (7%) of 247 patients had de novo HBV markers from 5 to 69 months. At the time HBV DNA was detected, the mean alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the patients was 53.3 ± 36.4 IU/L and 54.5 ± 33.0 IU/L, respectively. All patients received nucleos(t)ide analogues (NAs). The therapy led to a statistically significant decrease in the mean ALT level to 31.5 ± 24.2 IU/L (p = 0.049) and AST to 33.33 ± 21.5 IU/L (p = 0.025). In most cases (18 persons, 81%), no serum HBV DNA was detected after treatment (6 ± 3 months).Conclusion. Timely detection of de novo HBV risk factors, early diagnosis and immediate treatment can prevent severe graft damage.