Redevelopment of Hepatitis B Surface Antigen After Renal Transplantation

Marcellin, Patrick; Giostra, Emile; Martinot‐Peignoux, Michèle; Loriot, M.A.; Jaegle, Marie Lorraine; Wolf, P; Degott, Claude; Degos, Françoise; Benhamou, Jean Pierre

doi:10.1016/0016-5085(91)70034-u

Cited by 75 publications

(36 citation statements)

References 12 publications

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“…[9][10][11][12][13] Several recent studies have, however, demonstrated the reactivation of HBV in HBsAg-negative and anti-HBcpositive healthy individuals. Indeed, HBV reactivation was documented in patients positive for anti-HBc but negative for HBsAg after renal transplantation 17,18 and after intensive chemotherapy. 24 Confirming these previous findings, we showed here the reactivation of latently infected HBV in a leukemia patient who was positive for anti-HBc and anti-HBs in the absence of HBsAg under newly introduced immunocompromised conditions.…”

Section: Discussionmentioning

confidence: 99%

“…14 Evidence of possible HBV reactivation in anti-HBcpositive but HBsAg-negative individuals, because of immunosuppression, can also be seen in HIV-infected patients 15,16 and in the recipients of kidney transplants. 17,18 Although these findings suggest that HBV reactivation does occur in anti-HBc-positive but HBsAg-negative healthy individuals under certain immunosuppressive conditions, little is known about the mechanism of viral reactivation and the characteristics of the reactivated HBV in these individuals.We encountered a patient with leukemia who was positive for anti-HBc and who developed fatal liver A 66-year-old man with chronic B-cell leukemia who had antibody to hepatitis B core antigen (anti-HBc) but not hepatitis B surface antigen (HBsAg) suffered from lethal hepatitis caused by hepatitis B virus (HBV) reactivation. He initially lacked circulating viral genomes in his sera and did not have a past history of liver dysfunction.…”

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confidence: 97%

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confidence: 97%

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Reactivation of latently infected hepatitis B virus in a leukemia patient with antibodies to hepatitis B core antigen

Marusawa

Imoto

Ueda

et al. 2001

Journal of Gastroenterology

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A 66-year-old man with chronic B-cell leukemia who had antibody to hepatitis B core antigen (anti-HBc) but not hepatitis B surface antigen (HBsAg) suffered from lethal hepatitis caused by hepatitis B virus (HBV) reactivation. He initially lacked circulating viral genomes in his sera and did not have a past history of liver dysfunction. In this patient, the immunosuppressive condition introduced by disease progression of leukemia induced reactivation of dormant HBV, and the withdrawal of chemotherapy resulted in fatal liver failure. Mutation-specific assay based on competitive polymerase chain reaction (PCR) and sequencing analyses revealed the predominant reactivation of an HBV strain with missence mutation (point mutation G-to-A at nucleotide 1896) in the precore regions, as well as point mutations in the core promoter regions. Therefore, it is important to note the risk of HBV reactivation, with resulting lethal hepatic failure, in anti-HBc-positive healthy individuals, even when they lack HBsAg. who receive immunomodulating therapy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 97%

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confidence: 97%

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Reactivation of latently infected hepatitis B virus in a leukemia patient with antibodies to hepatitis B core antigen

Marusawa

Imoto

Ueda

et al. 2001

Journal of Gastroenterology

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“…5 There were also reports that HBV DNA was demonstrated with polymerase chain reaction in the serum collected before transplantation, despite the absence of detectable HBsAg, which redevelops HBsAg after renal or liver transplantation. 12,13 Thereore, the detection of HBV DNA before transplantation is thus considered to be useful for identifying this possible complication.…”

Section: Discussionmentioning

confidence: 99%

Acutely Exaggerated Hepatitis B Induced by the Withdrawal of Immunosuppressants in a Seroconverted Renal Transplant Recipient: Report of a Case

Gunji

Sakamoto²,

Sato³

et al. 2002

Surgery Today

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The long-term reciprocal impact of renal transplantation on infection by hepatitis B virus (HBV) is still a matter of intense debate, and the topic remains controversial. We herein report the case of a 50-year-old male asymptomatic HBV carrier who had seroconverted to positive anti-HBe antibody (Ab) and received a kidney transplantation from a cadaver donor (HB surface(s) antigen (Ag)-negative). Nine months later, his kidney function deteriorated due to chronic rejection, and hemodialysis was temporarily required. Triple drug therapy (cyclosporine, prednisolone, azathioprine) for immunosuppression was changed to two-drug therapy (cyclosporine and prednisolone) at a reduced dosage because of this episode. After that episode, severe hepatitis with HBV antigenemia developed without any change in the serological state. The levels of DNA polymerase in a potential recipient from a cadaveric donor should be checked before transplantation to predict the occurrence of hepatitis when the recipient is an asymptomatic carrier of HBV, especially in cases of serologically HBeAg-negative, and anti-HBeAb-positive carriers.

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“…HBV can archive in hepatocytes for life and reactivates after a patient receives immunosuppression and chemotherapy [7][8][9]. In HBsAg-positive patients receiving chemotherapy, the risk of HBV reactivation is high.…”

Section: Introductionmentioning

confidence: 99%

Long-term use of methotrexate does not result in hepatitis B reactivation in rheumatologic patients

2015

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Prevalence of HBsAg positive rheumatologic patients treated with MTX in Thailand was only 0.58%, which was lower than the general Thai population. About one-third of the patients had exposure to HBV as demonstrated by presence of anti-HBc IgG (37.6%), but none of them had hepatitis B reactivation during 9.9 years of MTX treatment. Moreover, one case with HBsAg positive had been receiving MTX without HBV prophylaxis for 5 years but had no evidence of HBV flare and evidence of fibrosis. From our study, long-term MTX in patients exposed to HBV was safe and not associated with hepatitis flare. However, more study is needed as to whether HBV prophylaxis is required.

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Redevelopment of Hepatitis B Surface Antigen After Renal Transplantation

Cited by 75 publications

References 12 publications

Reactivation of latently infected hepatitis B virus in a leukemia patient with antibodies to hepatitis B core antigen

Reactivation of latently infected hepatitis B virus in a leukemia patient with antibodies to hepatitis B core antigen

Acutely Exaggerated Hepatitis B Induced by the Withdrawal of Immunosuppressants in a Seroconverted Renal Transplant Recipient: Report of a Case

Long-term use of methotrexate does not result in hepatitis B reactivation in rheumatologic patients

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