Reactivation of Hepatitis B virus in kidney transplant recipients with previous clinically resolved infection: A single-center experience

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Meng, C (Author) Other; Belino, C (Author) Other; Pereira, L (Author) Other; Pinho, A (Author) Other; Sampaio, S (Author) FMUP; Tavares, I (Author) Other; Bustorff, M (Author) Other; Sarmento A (Author) FMUP; Pestana M (Author) FMUP

Journal

Title: Nefrologia

Vol. 38

Pages: 545-550

ISSN: 0211-6995

Publisher: Grupo Aula Medica S.A.

Indexing

ISI Web of Knowledge - 8 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00P-R8H

DOI: 10.1016/j.nefro.2018.02.004

Abstract (EN): Background: Hepatitis B virus (HBV) reactivation in kidney transplant recipients (KTR) involves important morbidity and mortality. Despite being more common in patients who are HBsAg-positive, it may occur in patients with clinically resolved infection (HBsAg-negative and anti-HBc-positive), in whom the presence of the protective anti-HB antibody is thought to decrease the risk of reactivation. Data regarding reactivation rates in this population are scarce. Objective: To retrospectively evaluate the risk of HBV reactivation in KTR with previously resolved infection. Material and methods: Retrospective cohort study including patients who underwent a kidney transplant between January 1994 and December 2014 with resolved HBV infection at the time of transplantation (anti-HBc seropositivity without detectable HBsAg, with or without anti-HB-positive antibodies and normal liver enzymes). Results: Out of 966 patients, 95 patients with evidence of resolved HBV infection were analyzed, of which 86 had a titer of anti-HBs >10 mIU/ml. Mean follow-up time was 93 months; 12 patients had lost anti-HBs. Two patients showed evidence of reactivation. Risk factors associated with loss of anti- HBs were elderly age (>60) and occurrence of acute graft rejection (p < 0.05). Conclusion: The risk of HBV reactivation in KTR with previously resolved infection is not negligible at 2%. Elderly age and acute rejection were associated with loss of anti-HBs, and these patients may benefit from closer monitoring of HBV DNA levels. Routine serology and/or HBV viral load monitoring in HBsAg-negative, anti-HBc-positive patients is recommended and should be emphasized in these patients. (C) 2018 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6