Long-term clinical and virological outcome after liver transplantation for cirrhosis caused by chronic delta hepatitis.

Abstract

Liver transplantation for liver diseases related to hepatitis B virus (HBV) and hepatitis delta virus (HDV) remains problematic because of the risk of viral recurrence. We report here the long-term virological outcome of patients transplanted for HDV-related liver cirrhosis (HDV cirrhosis). From December 1984 to December 1990, 76 patients with HDV cirrhosis underwent liver transplantation. Before transplantation, all the patients were HBsAg-positive/anti-HDV positive, and all but one were HBV DNA-negative by dot blot hybridization. HDV RNA was detected by HDV RT-PCR and liver HDAg by fluorescent HDV Ab. After transplantation, all the patients except four received continuous long-term anti-HBs passive immunoprophylaxis. The actuarial 5-year survival was 88%. All patients who did not receive anti-HBs immunoprophylaxis remained HBsAg-positive and developed hepatitis. Among the 68 patients receiving antiHBs immunoprophylaxis with a minimum follow-up of 2 months, HBsAg reappeared in 7 (10.3%) after a mean of 17 months. These seven patients developed hepatitis, with simultaneous HBV and HDV replication; and four cleared later HBsAg. Patients without HBV reinfection were studied for HDV reinfection: liver HD Ag or serum HDV RNA were present in 88% of the patients during the first year, without developing hepatitis; however, they were no longer detectable after 2 years in 95% of the patients. In conclusion, liver transplantation for HDV cirrhosis gives good results, with a 5-year actuarial survival of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

• Authors: D Samuel, A L Zignego, M Reynes, C Feray, J L Arulnaden, M F David, M Gigou, A Bismuth, D Mathieu, P Gentilini
• Journal: Hepatology (Baltimore, Md.) (Hepatology) Vol. 21 Issue 2 Pg. 333-9 (Feb 1995) ISSN: 0270-9139 [Print] United States
• PMID: 7843702 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• DNA, Viral
• Hepatitis B Surface Antigens
• RNA, Viral

Topics

• Actuarial Analysis
• Adult
• Chronic Disease
• DNA, Viral (blood)
• Female
• Follow-Up Studies
• Hepatitis B (complications, therapy)
• Hepatitis B Surface Antigens (blood)
• Hepatitis B virus (genetics)
• Hepatitis D (complications, therapy)
• Hepatitis Delta Virus (genetics)
• Humans
• Immunotherapy, Adoptive
• Liver Cirrhosis (blood, mortality, surgery, virology)
• Liver Transplantation
• Male
• Middle Aged
• RNA, Viral (blood)
• Recurrence
• Survival Rate
• Time Factors
• Treatment Outcome