Epidemiological characteristics of de novo hepatitis B infection in liver transplant recipients-An experience from a tertiary care centre in Qatar

De novo Hepatitis B Virus Infection in a Post-transplant Patient Causing Stage 4 Cirrhosis Necessitating Retransplant

Hepatitis B virus (HBV) is a common cause of liver cirrhosis worldwide, almost always as a result of HBV infection at birth or a very young age. HBV very rarely causes cirrhosis when contracted as an adult. Notably, the risk of HBV progression to cirrhosis is higher in immunocompromised patients, such as liver transplant patients, although it is still quite rare. We present a liver-transplant patient who acquired a de novo HBV infection and developed HBV-associated cirrhosis requiring retransplantation.

Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation

Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to examine its course in liver transplant patients. Materials and Methods: Prevalence of de novo HBV-infections was extracted from our local transplant data base. Analysis focused on the moment of HBV-detection and on the long-term follow-up in terms of biochemical and histological changes over 30 years. Results: 46 patients were identified with the diagnosis of de novo hepatitis B. Median time from liver transplantation to diagnosis was 397 days (7-5505). 39 patients received antiviral therapy. No fibrosis progression could be detected, whereas the grade of inflammation significantly lessened from the moment of HBV detection to the end of histological follow-up over a median of 4344 days (range 123-9490). Patients with a poor virological control demonstrated a significantly poorer overall survival. Conclusions: De novo hepatitis B in liver transplant patients is a condition that can be controlled very well without significant fibrosis progression or graft loss if recognized on time within a regular transplant follow-up schedule.