[Hepatitis B and D recurrence after liver transplantation]

Area of Science:

• Hepatology
• Transplantation Immunology
• Virology

Background:

• Hepatitis B Virus (HBV) and Hepatitis Delta Virus (HDV) co-infection leads to end-stage liver disease.
• High rates of hepatitis recurrence (70-100%) are reported post-liver transplantation in these patients.
• Liver transplantation is a potential treatment for HBV/HDV-related end-stage liver disease in Italy.

Purpose of the Study:

• To report outcomes of liver transplantation in HBsAg-positive patients, including those with HDV infection.
• To analyze recurrence patterns and clinical course following transplantation.
• To investigate the significance of HDV-RNA detection in HBsAg-negative post-transplant patients.

Main Methods:

• Retrospective analysis of 72 liver transplants in 60 patients (June 1983 - May 1989).
• Focus on 26 HBsAg-positive patients (19 with HDV infection).
• Detailed follow-up of 17 patients (>7 months) and clinical course of 4 HBV reinfection cases.

Main Results:

• Hepatitis recurrence observed in 3 out of 4 patients with HBV reinfection.
• HDV-RNA detected in 5 post-transplant patients who were HBsAg and HBV/HDV replication marker negative.
• These 5 patients showed no hepatitis recurrence or clinical deterioration.

Conclusions:

• Liver transplantation for HBV/HDV infection carries a significant risk of hepatitis recurrence.
• The presence of HDV-RNA in HBsAg-negative patients post-transplant may not indicate active disease or recurrence.
• Further research is needed to understand the implications of HDV-RNA in these specific patient cohorts.