Francesco Tandoi1, Gian Paolo Caviglia2, Fabrizia Pittaluga3, Maria Lorena Abate2, Antonina Smedile2, Renato Romagnoli4, Mauro Salizzoni1. 1. Liver Transplant Center, General Surgery Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza, Molinette Hospital, University of Turin, Turin, Italy. 2. Laboratory of Digestive and Liver Physiopathology, Department of Medical Sciences, A.O.U. Città della Salute e della Scienza, Molinette Hospital, University of Turin, Turin, Italy. 3. Laboratory of Microbiology and Virology, Department of Laboratory Medicine, A.O.U. Città della Salute e della Scienza, Molinette Hospital, University of Turin, Turin, Italy. 4. Liver Transplant Center, General Surgery Unit, Department of Surgical Sciences, A.O.U. Città della Salute e della Scienza, Molinette Hospital, University of Turin, Turin, Italy. Electronic address: renato.romagnoli@unito.it.
Abstract
BACKGROUND: Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. AIMS: we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. METHODS: In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. RESULTS: In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p<0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs<58 mIU/mL. CONCLUSIONS: In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors.
BACKGROUND:Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. AIMS: we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. METHODS: In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. RESULTS: In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (p<0.0001). All anti-HBc-positive donors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBs<58 mIU/mL. CONCLUSIONS: In deceased donors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors.
Authors: Gian Paolo Caviglia; Antonella Zorzi; Mario Rizzetto; Massimo Mirandola; Antonella Olivero; Giada Carolo Journal: Diagnostics (Basel) Date: 2021-11-24
Authors: Gian Paolo Caviglia; Silvia Martini; Alessia Ciancio; Grazia Anna Niro; Antonella Olivero; Rossana Fontana; Francesco Tandoi; Chiara Rosso; Renato Romagnoli; Giorgio Maria Saracco; Antonina Smedile; Mario Rizzetto Journal: J Adv Res Date: 2021-03-02 Impact factor: 10.479