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Hepatitis B virus infection after renal transplantation in the presence of antibody to hepatitis B surface antigen immunity

Authors
 KYUN-HWAN KIM  ;  SANG HOON AHN  ;  KWANG-HYUB HAN  ;  YOUNG MYOUNG MOON  ;  CHAE YOON CHON  ;  YU SEUN KIM  ;  KWAN SIK Lee  ;  YONG HAN PAIK  ;  HYO YOUNG CHUNG 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.19(8) : 847-853, 2004 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2004
MeSH
Adult ; Amino Acid Sequence ; Base Sequence ; Clinical Trials as Topic ; Female ; Hepatitis B/etiology* ; Hepatitis B/immunology ; Hepatitis B Antibodies/blood* ; Hepatitis B Surface Antigens/immunology* ; Hepatitis B virus/genetics ; Hepatitis B virus/immunology* ; Humans ; Immunity ; Kidney Transplantation/adverse effects* ; Liver Function Tests ; Male ; Middle Aged ; Molecular Sequence Data ; Polymerase Chain Reaction
Keywords
‘a’ determinant mutants ; antibody to hepatitis B surface antigen immunity ; hepatitis B virus infection ; renal transplantation
Abstract
BACKGROUND AND AIM: Hepatitis B virus (HBV) infection has been known to be hampered by immunity against hepatitis B surface antigen (HBsAg). However, HBV with mutations within the common antigenic epitope of HBsAg, the "a" determinant region, can escape from humoral immunity. Moreover, HBV infection by "a" determinant mutants in chronic HBV patients has been reported after renal transplantation. In the present study, the authors investigated HBV infection after renal transplantation despite passive immunization or resolved HBV infection. METHODS: A total of 1682 patients who underwent a renal transplant between 1979 and 1998 at the Severance Hospital, Yonsei University College of Medicine, Korea, were enrolled. The sequence of the HBV genome was analyzed from two patients with antibody to HBsAg (anti-HBs) immunity. RESULTS: Of 1682 patients who were HBsAg negative before transplantation, 21 patients were found to be HBsAg positive, with elevated aspartate aminotransferase and alanine aminotransferase levels after transplantation. Interestingly, six of 21 (28.6%) patients were anti-HBs positive before the transplantation. Sequence analysis of the cloned HBV from two of six patients with anti-HBs immunity showed no evidence of significant mutations within the "a" determinant region, suggesting a wild-type of HBV. Their donors were not exposed to HBV before transplantation (all HBV markers were negative). Seven deaths of 21 patients were ascribed to HBV-related complications. CONCLUSIONS: Regardless of anti-HBs immunity, HBV infection occurred in immunosuppressed patients in a high endemic area. The molecular mechanism and clinical impact of HBV infection after renal transplantation in patients with anti-HBs immunity should be further reappraised.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2003.03303.x/abstract
DOI
10.1111/j.1440-1746.2003.03303.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Medical Research Center (임상의학연구센터) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Paik, Yong Han(백용한)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Chon, Chae Yoon(전재윤)
Chung, Hyo Young(정효영)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111367
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