Unexpected hepatitis B virus transmission after liver transplant from nucleic acid testing- and serology-negative liver donors who are hepatitis C viremic.

Autor: Kreitman KR; MUH James D. Eason Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA., Kothadia JP; MUH James D. Eason Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA., Nair SP; MUH James D. Eason Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA., Maliakkal BJ; MUH James D. Eason Transplant Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Jazyk: angličtina
Zdroj: Hepatology research : the official journal of the Japan Society of Hepatology [Hepatol Res] 2021 Dec; Vol. 51 (12), pp. 1242-1246. Date of Electronic Publication: 2021 Jun 23.
DOI: 10.1111/hepr.13680
Abstrakt: The opioid epidemic has led to increased availability of organs for liver transplantation. The success of direct-acting antiviral therapy for hepatitis C (HCV) has led to the acceptance of HCV viremic donor organs. Nucleic acid testing (NAT) has led to increased detection of HCV and hepatitis B (HBV) in potential donors. A total of 36 patients underwent liver transplantation from donation after brain death donors who were HCV NAT-positive, and three of them were diagnosed with HBV several months after. All three recipients received livers from HCV viremic donors who were negative for HBV by serology and NAT. Soon after liver transplantation, HCV was treated, and all achieved sustained virologic response. They became HBV DNA-positive shortly thereafter. To date, there have been no reported cases of unexpected HBV transmission since universal donor NAT was implemented in 2013. We postulate that the inhibitory effect of HCV viremia on HBV may have prolonged the "NAT window period" in these donors beyond the 20-22 days quoted for solitary HBV infection. These cases highlight the need for more intensive and prolonged screening for HBV in recipients of livers from HCV viremic donors.
(© 2021 The Japan Society of Hepatology.)
Databáze: MEDLINE
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