Presence of Intrahepatic (Total and ccc) HBV DNA Is Not Predictive of HBV Recurr

November 13, 2006

www.hbvadvocate.org

AASLD 2006

#786. Presence of Intrahepatic (Total and ccc) HBV DNA Is Not Predictive of

HBV Recurrence after Liver Transplant (OLT)

M. Hussain; C. Soldevila-Pico; S. Emre; V. Luketic; A. S. Lok

Background:

Previous studies reported that HBV DNA can be detected in liver biopsies

from patients (pts) who had OLT for hepatitis B despite the absence of

serological markers of HBV recurrence. However, quantification of HBV DNA

was not performed in most studies and presence of covalently closed circular

(ccc) DNA was not analyzed.

Aim:

To quantify intrahepatic (total and ccc) HBV DNA in explant and post-OLT

liver and correlate it with HBV recurrence post-OLT.

Patients and Methods:

Explant liver from 8 pts and post-OLT biopsies from 26 pts were analyzed.

Total and ccc HBV DNA were quantified using real time PCR. Serum HBV DNA was

quantified by the COBAS Amplicor assay.

Results:

Among the 8 patients (pts) with explant liver, 7 were HBeAg+ve, 8 had

detectable serum HBV DNA, and 0 were receiving antiviral therapy prior to

OLT. Total HBV DNA was detected in 7 and ccc DNA in 6 pts. HBeAg+ve patients

had higher concentrations of ccc DNA (-.87 vs -3.27 log0copies/cell,

p=0.037) and higher ratio of ccc/total HBV DNA: .7% vs. 3.% (p=0.04) than

HBeAg-ve pts.

After a median follow-up of 8 months (range 5-35), 2(%) pts had HBV

recurrence. Mean serum HBV DNA level at OLT in these 2 patients was higher

than in pts without recurrence (8.79 vs 5.2 log0 copies/mL, p=0.046).

Concentrations of total and ccc HBV DNA were also higher in these 2 pts but

the difference was not significant.

Five biopsies from 26 patients collected between 7 days to 48 months

post-OLT were studied. 8 pts had detectable total (6/6) and ccc (2/6) HBV

DNA in their biopsies, of these 2 had HBV recurrence. 4 pts had detectable

total (27/30 biopsies) but not ccc (0/30 biopsies) HBV DNA, of these had

HBV recurrence. 4 pts had undetectable total and ccc HBV DNA in all their

biopsies (0/5), none of which had HBV recurrence. The concentrations of

total and ccc DNA in post-OLT biopsies were 2.7 and .2 log lower than

explant livers. All 3 pts with HBV recurrence were HBeAg+ve pre-OLT compared

to only 3/20 pts without recurrence (p=0.00). All 3 pts with HBV recurrence

had detectable total HBV DNA in their post-OLT biopsies compared to 9/23 pts

without HBV recurrence. 2 of the 3 pts with HBV recurrence had detectable

ccc DNA in their post-OLT biopsies compared to 6/23 without HBV recurrence

(p=0.25).

Conclusions:

Total and ccc HBV DNA could be detected in the explant livers of most pts

with hepatitis B including those who had undetectable HBV DNA in serum.

Total but not ccc HBV DNA could be detected in post-OLT liver biopsies of

most pts despite undetectable serum HBV DNA and HBsAg. Detection of HBV DNA

in explant liver or post-OLT biopsies does not predict HBV recurrence

post-OLT.

http://www.hbvadvocate.org/news/reports/HBV_AASLD_2006/HBV%20Abstracts/HBV%20abs\

tractsOct29.htm#HBV782

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November 13, 2006