HBV infection de novo in patients after orthotopic liver transplantation from deceased donors

Orthotopic liver transplantation (OLT) from a deceased donor is an effective treatment for the management of terminal stages of cirrhosis and hepatocellular carcinoma. Among these individuals are those who have not previously encountered hepatitis B virus (HBV) markers (HBsAg, anti-HBcor IgG) prior to OLT. It is possible for them to develop hepatitis due to the aforementioned virus following OLT. This particular manifestation of the disease is regarded as de novo.
The objective: to examine clinical and laboratory parameters and evaluate the efficacy of antiviral therapy (tenofovir) in patients with HBV-related hepatitis that developed after de novo OLT.
Materials and Methods. A total of 108 patients. The subjects were stratified into two groups. The initial group comprised 16 patients in whom HBV infection occurred de novo subsequent to OLT registration. The second group (n = 68) comprised subjects who were observed for HBV infection without OLT. The median age of subjects in the first group was 49.5 years (Q25-75: 42-56).
Results. Anamnestic analysis showed that primary biliary cholangitis was the main cause of liver lesions (7/18/38,89 %), which led to OLP. There was no typical clinical picture of acute jaundice from hepatitis. The subjects had lower platelet and bilirubin levels than patients with the acute form of hepatitis (p < 0.031). Their levels of ALT, AST and GGTP were also lower (p < 0.001) and did not differ from those in chronic hepatitis. Administration of etiotropic therapy (Tenofovir) in the subjects resulted in undetectable viral load in 100 % of cases, HBsAg seroconversion was achieved in five subjects (5/18/27.78 %).
Conclusion. The clinical and laboratory characteristics of de novo HBV infection subsequent to OLT are analogous to those of chronic HBV infection in the absence of OLT. Etiotropic therapy (Tenofovir) in these patients effectively suppresses HBV replication. Etiotropic therapy (Tenofovir) in these patients effectively suppresses HBV replication.

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