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Epidemiological characteristics of de novo hepatitis B infection in liver transplant recipients—An experience from a tertiary care centre in Qatar

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submitted on 2023-03-15, 08:05 and posted on 2023-03-15, 09:01 authored by Arun P. Nair, Sreethish Sasi, Muna S. Al‐Maslamani, Prem Chandra, Samar A. Hashim, Sulieman Abu Jarir, Moutaz Derbala

Background

The emergence of hepatitis B surface antigen in a patient with previously negative hepatitis B virus (HBV) serology post-orthotropic liver transplant (OTLX) is known as de novo hepatitis B (DNHB). As there are no data on patients with DNHB available from Qatar, we aim to do a pioneer study indexing their clinical profile and epidemiology of patients with DNHB in Qatar.

Materials and Methods

This descriptive epidemiological study was done by retrospectively reviewing records of 159 post-OTLX patients. HBV serology of these patients post-OTLX was reviewed, and 17 were identified as DNHB cases. Baseline epidemiological characteristics were defined and compared between DNHB cases and the rest. DNHB cases were analyzed statistically using the chi-square test and Kaplan-Meier curve.

Results

The majority of the subjects were men (65%) and Qataris (40%). Mean age was 57.4 ± 12.5 years. Bulk of them underwent OTLX in China (44%). The overall incidence of DNHB was 10.7%, with transplants in China having significantly higher incidence than transplants from all other countries. The mortality rate was 23.5% in DNHB cases compared to 2.8% in non-DNHB. 67% of patients survived at least 64 months after the diagnosis of DNHB. Five-year survival did not vary significantly between those with DNHB and those without.

Conclusion

Orthotropic liver transplant in centers selecting donors liberally without screening for HBV poses the risk of DNHB. We recommend having protective levels of HBs antibodies before OTLX. Prophylactic antiviral treatment should be considered until peri-operative HBV transmission has been excluded by screening hepatic tissue for HBV DNA.

Other Information

Published in: Transplant Infectious Disease
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: http://dx.doi.org/10.1111/tid.13444

History

Language

  • English

Publisher

Wiley

Publication Year

  • 2020

Institution affiliated with

  • Hamad Medical Corporation

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