Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
ADF | adenofovir |
AIH | autoimmune hepatitis |
ALD | alcoholic liver disease |
ALF | acute liver failure |
ALT | alanine aminotransferase |
Anti-HBc | hepatitis B core antibody |
Anti-HBe | hepatitis B e antibody |
Anti-HBs | hepatitis B surface antibody |
AST | aspartate aminotransferase |
ETV | entecavir |
ESLD | end stage liver disease |
HBV | hepatitis B virus |
HBcAb | hepatitis B core antibody |
HBeAg | hepatitis B e antigen |
HBIG | hepatitis B immunoglobulin |
HBsAg | hepatitis B surface antigen |
HCC | hepatocellular carcinoma |
HCV | hepatitis C virus |
IFN | interferone |
ITBL | ischemic type biliary lesions |
LT | liver transplantation |
LAM | lamivudine |
NA | nucleos(t)ide analog |
NASH | nonalcoholic steatohepatitis |
PBC | primary biliary cholangitis |
PSC | primary sclerosing cholangitis |
TA | transaminase |
TDF | tenofovir |
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De Novo HBV-Infection after LT | HbcAb+ LT without De Novo HBV-Infection | p | |
---|---|---|---|
n = 46 | n = 64 | ||
Sex | 0.401 | ||
female | n = 17 (37.0%) | n = 21 (33.8%) | |
male | n = 29 (63.0%) | n = 43 (66.2%) | |
Mean age at LT (std) | 49.26 years (11.5) | 54.43 years (12.8) | 0.031 |
LT Indication | 0.005 | ||
cirrhosis | n = 24 (52.2%) | n = 29 (45.3%) | |
HCC | n = 3 (6.5%) | n = 15 (23.4%) | |
HCV | n = 3 (6.5%)0 | n = 5 (7.8%) | |
autoimmune | n = 11 (23.9%) | n = 4 (6.3%) | |
other | n = 4 (8.7%) | n = 11 (17.2%) | |
Backbone immune suppression | |||
CNI | n = 40 (87.0%) | n = 63 (98.4%) | |
MMF | n = 3 (6.5%) | n = 1 (0.6%) | 0.042 |
Cortison | n = 3 (6.5%) | n = 0 (0%) | 0.06 |
Combination therapy | 30 (65.2%) | 31 (48.4%) | |
Reasons for Diagnosis of HBV | n.a | ||
elevetaed TAs | n = 25 (54.3%) | ||
elevated bilirubine/icterus | n = 2 (4.3%) | ||
clinical signs of infection | n = 9 (19.6%) | ||
routine check | n = 2 (4.3%) | ||
Median Observation Period min-max) | 4344 days (123–9490) | 2133 days (150–6270) | <0.001 |
Interquartile range Q1/Q3 | 2708.5/6191.5 days | 1140/3499.25 days | |
Median histological observation (min-max) | 2362 days (106–8045) | 1825 (184–3654) | <0.001 |
Status in last follow-up | 0.69 | ||
alive | n = 27 (58.7%) | n = 41 (64.1%) | |
deceased | n = 19 (41.3%) | n = 23 (35.9%) | |
HBcAb-Status of liver transplant | n.a. | ||
HBcAb+ | n = 14 (30.4%) | n = 64 (100%) | |
HBcAb− | n = 32 (69.6%) | n = 0 (0%) | |
HbsAG/HBV-DNA in last follow-up | n.a. | ||
HbsAG/HBV-DNA+ | n = 32 (69.6%) | n = 0 (0%) | |
HbsAG/HBV-DNA− | n = 11 (23.9.6%) | n = 64 (100%) | |
no information | n = 3 (6.5%) |
De Novo HBV-Infection after LT n = 46 | ||
---|---|---|
Diagnosis of HBV-infection | ||
HBsAg-positive | n = 46 (100%) | |
HBV-DNA available | n = 29 (63.0%) | |
Median laboratory parameters at diagnosis of de novo HBV-infection (min-max) | ||
norm/threshold | ||
HBV-DNA | <100 cop/mL | 7,056,000 (13,460–477,000,000) |
ALT | <41 U/l | 32 (8–256) |
AST | <50 U/l | 34 (11–402) |
bilirubine | <1.2 mg/dl | 0.7 (0.2–9.5) |
platelets | 150–370/nl | 162.5 (96–1127) |
INR | 0.9–1.25 s | 1.1 (0.88–1.6) |
pharmacological treatment | ||
NA-monotherapy | n = 27 (58.7%) | |
TDF/ETV | n = 14 (30.4%) | |
ADV/LAM | n = 13 (28.3%) | |
NA-combination therapy | n = 14 (30.4%) | |
NA + NA | n = 13 (28.3%) | |
NA + HBIg | n = 1 (2.2%) | |
Re-LT | n = 2 (4.3%) | |
Treatment success | ||
HbsAg/HBV-DNA+ | n = 32 (69.6%) | |
HbsAg/HBV-DNA− | n = 11 (23.9.6%) | |
HBsAg seroconversion | n = 13 (28.3%) |
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Ossami Saidy, R.R.; Eurich, F.; Postel, M.P.; Dobrindt, E.M.; Feldkamp, J.; Schaper, S.J.; Pratschke, J.; Globke, B.; Eurich, D. Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation. Medicina 2021, 57, 767. https://doi.org/10.3390/medicina57080767
Ossami Saidy RR, Eurich F, Postel MP, Dobrindt EM, Feldkamp J, Schaper SJ, Pratschke J, Globke B, Eurich D. Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation. Medicina. 2021; 57(8):767. https://doi.org/10.3390/medicina57080767
Chicago/Turabian StyleOssami Saidy, Ramin Raul, Franziska Eurich, Maximilian Paul Postel, Eva Maria Dobrindt, Jasper Feldkamp, Selina Johanna Schaper, Johann Pratschke, Brigitta Globke, and Dennis Eurich. 2021. "Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation" Medicina 57, no. 8: 767. https://doi.org/10.3390/medicina57080767
APA StyleOssami Saidy, R. R., Eurich, F., Postel, M. P., Dobrindt, E. M., Feldkamp, J., Schaper, S. J., Pratschke, J., Globke, B., & Eurich, D. (2021). Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation. Medicina, 57(8), 767. https://doi.org/10.3390/medicina57080767