Persistence of occult hepatitis B after removal of the hepatitis B virus-infected liver.

Ciesek, Sandra; Helfritz, Fabian A; Lehmann, Ulrich; Becker, Thomas; Strassburg, Christian P; Neipp, Michael; Ciner, Ayse; Fytili, Paraskevi et al. · J Infect Dis · 2008

prospective_cohort · Level II

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Abstract

Occult hepatitis B is defined as the persistence of hepatitis B virus (HBV) DNA in persons without HBV surface antigen (HBsAg). The primary site for HBV persistence in persons with occult hepatitis B is considered to be the liver. We provide virological and immunological evidence for long-term persistence of HBV, even after removal of the infected liver, in 25 consecutive, randomly selected liver transplant recipients who tested positive for anti-HBV core antigen (anti-HBcAg) and negative for HBsAg at the time of transplantation. Furthermore, in a cohort of 101 anti-HBcAg-positive/HBsAg-negative patients, 2 showed clinical HBV reactivation after transplantation. Thus, these data indicate that a long-term extrahepatic HBV reservoir exists, which is relevant not only for liver transplantation but also for other types of transplantations, including bone marrow grafting.

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