Hepatitis B virus-associated liver disease after renal transplantation

A retrospective analysis of the first 200 recipients of renal transplants at the Johannesburg Hospital showed that 23 (11,5%) were chronic carriers of the hepatitis B virus (HBV) and a further 10 (5%) had previously been exposed to the virus as evidenced by detectable concentrations of antibody to the hepatitis B surface antigen in their serum. In no patient did graft function appear to suffer as a result of chronic HBV infection. However, 7 of the patients with hepatitis B surface antigenaemia had biochemical evidence of liver dysfunction. In 3 of these patients liver tissue was examined histologically; 2 had a macronodular cirrhosis and 1 chronic persistent hepatitis. One further patient developed acute fulminant B virus hepatitis and was the only one who died of liver failure in either group. Chronic infection with HBV may cause liver disease in renal transplant recipients, and strict techniques to limit the spread of the virus in renal transplant and dialysis units should continue to be enforced.