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肝移植受者长期随访中肝脏移植组织中可检测到的乙型肝炎病毒DNA的意义

Significance of detectable hepatitis B virus DNA in liver allograft tissue in long-term follow-up of liver transplant recipients.

作者信息

Mut Surmeli Deniz, Turan Ilker, Akay Sinan, Erensoy Selda, Ersoz Galip, Gunsar Fulya, Akarca Ulus, Karasu Zeki

机构信息

Department of Geriatrics, Ankara University School of Medicine, Ankara, Turkey.

Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkey.

出版信息

Hepatol Forum. 2021 May 21;2(2):43-48. doi: 10.14744/hf.2021.2021.0003. eCollection 2021 May.

Abstract

BACKGROUND AND AIM

The objective of this study was to evaluate the long-term presence of hepatitis B virus (HBV) DNA in the liver grafts of liver transplant patients who received hepatitis B immunoglobulin (HBIg) plus oral antiviral hepatitis B virus prophylaxis and had negative HBV serum markers.

MATERIALS AND METHODS

Patients aged 18 years or older who underwent liver transplantation for HBV-related liver disease, had negative serum viral markers, and had a liver biopsy at least 3 years after liver transplantation were eligible for this study. Clinical, serological, and pathological data were retrospectively obtained from medical records. The HBV DNA of liver biopsy specimens was assessed using the polymerase chain reaction technique.

RESULTS

A total of 150 patients were included. A positive HBV DNA result was seen in 18 (12%) of the liver biopsies. The presence of intrahepatic HBV DNA was not associated with pre-transplantation serum viral markers, type of pre- or post-transplantation antiviral treatment, or post-transplantation immunosuppressive treatment.

CONCLUSION

The findings suggest that while treatment with HBIg plus oral antiviral as post-transplantation HBV prophylaxis may result in a percentage of patients with persistent HBV DNA in the graft, the presence of HBV DNA in the liver graft may not be related to clinical HBV recurrence.

摘要

背景与目的

本研究的目的是评估接受乙肝免疫球蛋白(HBIg)联合口服抗病毒药物预防乙肝病毒(HBV)的肝移植患者,其肝移植受者肝脏中HBV DNA的长期存在情况,且这些患者的血清HBV标志物呈阴性。

材料与方法

年龄在18岁及以上、因HBV相关肝病接受肝移植、血清病毒标志物呈阴性且在肝移植后至少3年进行肝活检的患者符合本研究条件。临床、血清学和病理数据通过回顾医疗记录获得。使用聚合酶链反应技术评估肝活检标本的HBV DNA。

结果

共纳入150例患者。18例(12%)肝活检显示HBV DNA结果为阳性。肝内HBV DNA的存在与移植前血清病毒标志物、移植前或移植后抗病毒治疗类型或移植后免疫抑制治疗无关。

结论

研究结果表明,虽然使用HBIg联合口服抗病毒药物作为移植后HBV预防措施可能会使一定比例的患者移植肝中持续存在HBV DNA,但肝移植中HBV DNA的存在可能与临床HBV复发无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/765d/9138924/6df3830dcfa5/hf-2-43-g001.jpg

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