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Article: Outcomes including liver histology after liver transplantation for chronic hepatitis B using oral antiviral therapy alone

TitleOutcomes including liver histology after liver transplantation for chronic hepatitis B using oral antiviral therapy alone
Authors
Issue Date2015
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2015, v. 21 n. 12, p. 1504-1510 How to Cite?
AbstractThe outcomes of hepatitis B virus (HBV)-related hepatitis after liver transplantation (LT) without hepatitis B immune globulin (HBIG) is not well documented. This study aims to determine the outcomes of chronic hepatitis B (CHB) patients using an HBIG-free regimen. All biopsies performed 3 months or more after LT in consecutive CHB patients transplanted from 2003 to 2012 were reviewed. None of the patients received HBIG. Results of all liver histologies were reviewed to determine the cause of graft dysfunction. Of the 435 patients transplanted during this period, 263 liver biopsies were performed in 144 patients. Thirty-six patients were positive for hepatitis B surface antigen (HBsAg) with undetectable HBV DNA at the time of biopsy, and none had histological evidence of HBV infection. Of the 263 biopsies, 44 (17%) had evidence of fibrosis. There was a significantly higher rate of fibrosis in those with large duct obstruction compared to those without (51% versus 9%, respectively; P<0.001). Of the 291 patients without a liver biopsy during the same period, 43 were HBsAg+. Seven patients had evidence of virological rebound, of whom 6 had evidence of rtM204V/I mutation and 1 had recurrence of hepatocellular carcinoma with low-level rebound and wild-type virus. In conclusion, for patients without virological rebound, positive serum HBsAg was not associated with histological evidence of HBV-related hepatitis after LT. To prevent virological rebound, nucleos(t)ide analogues with higher barriers to resistance should be used. (C) 2015 AASLD.
Persistent Identifierhttp://hdl.handle.net/10722/214362
ISSN
2015 Impact Factor: 3.951
2015 SCImago Journal Rankings: 1.763
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFung, JYY-
dc.contributor.authorLo, CLR-
dc.contributor.authorChan, SC-
dc.contributor.authorChok, KSH-
dc.contributor.authorWong, CLT-
dc.contributor.authorSharr, WW-
dc.contributor.authorCheung, TT-
dc.contributor.authorChan, ACY-
dc.contributor.authorDai, WC-
dc.contributor.authorSin, SL-
dc.contributor.authorNg, IOL-
dc.contributor.authorLai, CL-
dc.contributor.authorYuen, RMF-
dc.contributor.authorLo, CM-
dc.date.accessioned2015-08-21T11:18:55Z-
dc.date.available2015-08-21T11:18:55Z-
dc.date.issued2015-
dc.identifier.citationLiver Transplantation, 2015, v. 21 n. 12, p. 1504-1510-
dc.identifier.issn1527-6465-
dc.identifier.urihttp://hdl.handle.net/10722/214362-
dc.description.abstractThe outcomes of hepatitis B virus (HBV)-related hepatitis after liver transplantation (LT) without hepatitis B immune globulin (HBIG) is not well documented. This study aims to determine the outcomes of chronic hepatitis B (CHB) patients using an HBIG-free regimen. All biopsies performed 3 months or more after LT in consecutive CHB patients transplanted from 2003 to 2012 were reviewed. None of the patients received HBIG. Results of all liver histologies were reviewed to determine the cause of graft dysfunction. Of the 435 patients transplanted during this period, 263 liver biopsies were performed in 144 patients. Thirty-six patients were positive for hepatitis B surface antigen (HBsAg) with undetectable HBV DNA at the time of biopsy, and none had histological evidence of HBV infection. Of the 263 biopsies, 44 (17%) had evidence of fibrosis. There was a significantly higher rate of fibrosis in those with large duct obstruction compared to those without (51% versus 9%, respectively; P<0.001). Of the 291 patients without a liver biopsy during the same period, 43 were HBsAg+. Seven patients had evidence of virological rebound, of whom 6 had evidence of rtM204V/I mutation and 1 had recurrence of hepatocellular carcinoma with low-level rebound and wild-type virus. In conclusion, for patients without virological rebound, positive serum HBsAg was not associated with histological evidence of HBV-related hepatitis after LT. To prevent virological rebound, nucleos(t)ide analogues with higher barriers to resistance should be used. (C) 2015 AASLD.-
dc.languageeng-
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021-
dc.relation.ispartofLiver Transplantation-
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.-
dc.rightsSpecial Statement for Preprint only Before publication: 'This is a preprint of an article accepted for publication in [The Journal of Pathology] Copyright © ([year]) ([Pathological Society of Great Britain and Ireland])'. After publication: the preprint notice should be amended to follows: 'This is a preprint of an article published in [include the complete citation information for the final version of the Contribution as published in the print edition of the Journal]' For Cochrane Library/ Cochrane Database of Systematic Reviews, add statement & acknowledgement : ‘This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 20XX, Issue X. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Please include reference to the Review and hyperlink to the original version using the following format e.g. Authors. Title of Review. Cochrane Database of Systematic Reviews 20XX, Issue #. Art. No.: CD00XXXX. DOI: 10.1002/14651858.CD00XXXX (insert persistent link to the article by using the URL: http://dx.doi.org/10.1002/14651858.CD00XXXX) (This statement should refer to the most recent issue of the Cochrane Database of Systematic Reviews in which the Review published.)-
dc.titleOutcomes including liver histology after liver transplantation for chronic hepatitis B using oral antiviral therapy alone-
dc.typeArticle-
dc.identifier.emailFung, JYY: jfung@hkucc.hku.hk-
dc.identifier.emailLo, CLR: loregina@hku.hk-
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hk-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.emailWong, CLT: wongtcl@hku.hk-
dc.identifier.emailSharr, WW: wwsharr@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailDai, WC: daiwc@hku.hk-
dc.identifier.emailNg, IOL: iolng@hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityLo, CLR=rp01359-
dc.identifier.authorityChan, SC=rp01568-
dc.identifier.authorityChok, KSH=rp02110-
dc.identifier.authorityWong, CLT=rp01679-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityNg, IOL=rp00335-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityYuen, RMF=rp00479-
dc.identifier.authorityLo, CM=rp00412-
dc.identifier.doi10.1002/lt.24218-
dc.identifier.pmid26194746-
dc.identifier.hkuros248226-
dc.identifier.volume21-
dc.identifier.issue12-
dc.identifier.spage1504-
dc.identifier.epage1510-
dc.identifier.isiWOS:000368138700008-
dc.publisher.placeUnited States-

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