Torre F, Wong P Y, Macartney M, Williams R, Naoumov N V
Institute of Hepatology, University College London, England.
J Med Virol. 1999 Sep;59(1):5-13.
Recurrence of hepatitis B virus (HBV) infection after liver transplantation is associated with varying degree of graft damage. The aim of the study was to investigate longitudinally the changes of wild-type and precore A1896HBV mutant viral populations after reinfection and their impact on liver graft damage. The wild-type HBV and A1896HBV strains were quantitated before and serially after orthotopic liver transplantation (OLT) in 14 hepatitis B surface antigen (HBsAg)-positive liver graft recipients (4 hepatitis B e antigen [HBeAg]+; 10 anti-HBe+). Before OLT, the wild-type precore HBV was present in all 4 HBeAg-positive patients and in 2/10 anti-HBe-positive patients; a mixed virus population was present in 6 patients; and A1896HBV mutant alone in 2 patients. After OLT, A1896HBV mutant appeared and gradually accumulated in 5/6 patients who had the wild-type HBV before OLT and 1 of these patients seroconverted from HBeAg to anti-HBe 52 months after transplantation. A mixed HBV population was present continuously in 6 patients before and after OLT. Of the 2 patients with A1896HBV only pre-OLT, the wild type appeared in one patient and the other patient retained persistently the A1896HBV mutant. There was no relationship between liver graft histology and the type of viral population at reinfection or at the end of follow up. Changes in the HBV population occur during follow up of recurrent hepatitis B in liver transplant recipients with frequent accumulation of precore A1896HBV mutants, but the type of viral population does not determine the severity of hepatitis B in the graft.
肝移植后乙型肝炎病毒（HBV）感染复发与不同程度的移植物损伤相关。本研究的目的是纵向调查再感染后野生型和前核心A1896 HBV突变病毒群体的变化及其对肝移植物损伤的影响。对14例乙型肝炎表面抗原（HBsAg）阳性的肝移植受者（4例乙型肝炎e抗原[HBeAg]阳性；10例抗-HBe阳性）在原位肝移植（OLT）前及OLT后连续进行野生型HBV和A1896 HBV毒株定量分析。OLT前，所有4例HBeAg阳性患者及2/10例抗-HBe阳性患者中存在野生型前核心HBV；6例患者存在混合病毒群体；2例患者仅存在A1896 HBV突变体。OLT后，A1896 HBV突变体在OLT前有野生型HBV的5/6例患者中出现并逐渐积累，其中1例患者在移植后52个月从HBeAg血清学转换为抗-HBe。6例患者OLT前后持续存在混合HBV群体。在OLT前仅存在A1896 HBV的2例患者中，1例出现野生型，另1例持续存在A1896 HBV突变体。肝移植物组织学与再感染时或随访结束时的病毒群体类型之间无相关性。肝移植受者复发性乙型肝炎随访期间HBV群体发生变化，前核心A1896 HBV突变体频繁积累，但病毒群体类型并不决定移植物中乙型肝炎的严重程度。
