Fibrosis progression in patients with recurrent chronic hepatitis C virus and occult hepatitis B co-infection after liver transplantation

Abstract

Background & Aim It is uncertain whether occult hepatitis Bvirus (HBV) co-infection will hasten progressive liver disease inchronic hepatitis C virus (HCV) patients post-liver transplantation.We compared fibrosis progression (fibrosis progression by at least 2-stage) and severe fibrosis (fibrosis stage 3 or 4) longitudinally on serialliver biopsies in patients with recurrent chronic HCV infection co-infected with occult HBV post-liver transplantation.Method One-hundred and eighteen consecutive hepatitis B surfaceantigen negative patients with virological and histological evidence ofrecurrent chronic HCV infection within 1-year post-liver transplan-tation were recruited into this study. HBV DNA was detected fromserum at the time of recurrent chronic HCV infection post-transplantation with PCR. Longitudinal liver biopsy was performedevery 3 monthly for the first year after transplantation and then annually until the time of analysis for fibrosis progression.Results Occult HBV co-infection was present in 41 of 118 (34.7%)consecutive patients with recurrent chronic HCV infection post-livertransplantation. At the time of analysis, all patients had undergonemultiple liver biopsies. The median time between the first and finalliver biopsy was 65.6 (range 20.5–89.4) months. Thirteen of the 41occult HBV co-infected patients compared with 16 of the 77 patientswithout occult HBV co-infection developed fibrosis progression(31.7% vs. 20.8% respectively, p = 0.87). Eight of the 41 occult HBVco-infected patients compared with 13 of the 77 patients withoutoccult HBV co-infection had severe fibrosis (19.5% vs. 16.9% respec-tively, p = 0.72). Conclusion Occult HBV co-infection in patients with recurrentchronic HCV infection was not associated with accelerated fibrosisprogression or severe fibrosis post-liver transplantation.