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Dynamic alteration of HBV markers on active HBV replicative recipients after liver transplantation: a preliminary report


   OBJECTIVE: To investigate the dynamic alternations of HBV markers of active HBV replicationrecipients receiving lamivudine prophylaxis after liver transplantation.METHODS: Serial liver biopsy samples and sera were obtained from 15 recipients and examined withenzyme-linked radioinmmunoassay for HBsAg, HBeAg, HBsAb, HBcAb and HBeAb, and fluorescentquantitative assay for quantitation of HBV DNA in serum. Immunohistochemical staining of HBsAg,HBcAg and HBV DNA hybridization in situ were used to detect HBV markers in liver biopsy samples.RESULTS: 100 mg lamivudine taken orally every, day for 2 weeks before transplantation enabled 12(80%) of 15 active viral replication recipients (HBV DNA positive) to converse to HBV DNA negative.HBsAb, HBcAb and HBeAb in serum emerged in 1-2 weeks after liver transplantation, and disappearedgradually within 6 months; HBV DNA fluorescent quantitative assay showed constant negativity in serum.Immunohistochemical staining of HBsAg, HBcAg and HBV DNA hybridization in situ in liver biopsysamples showed negative results synchorously. Eight of the 15 HBV active replication recipients lostHBV markers thoroughly both in serology and tissue staining as well as HBV DNA hybridization in situ ofserial liver biopsy samples from 12 to 44 weeks after liver transplantation. Should any of HBsAg, HBeAgin serology and HBsAg, HBcAg in immunohistochemical staining was positive, or HBV DNA detectablein serum, or HBV DNA hybridization in situ in liver tissue positive, allograft HBV reinfection or De novoliver allograft infection could be diagnosed. Furthermore, if associated with elevation of ALT andbilirubin, the diagnosis of HBV hepatitis recurrence could be established.CONCLUSION: Allograft HBV reinfection or De nuvo liver allograft infection in active viral replicationrecipients could be prevented with lamivudine regimen, and further clearance of HBV may be possible ifproper measures are taken.……