Patients who undergo liver transplantation for hepatitis B-related liver damage should receive lifelong antiviral treatment to keep the disease from coming back.
A new study shows that they lack cellular immunity against the disease, making recurrence likely if antiviral treatment is withdrawn. These findings are in the March issue of Liver Transplantation , a journal published by John Wiley & Sons. The article is also available online at Wiley Interscience ( www.interscience.wiley.com ).
Chronic hepatitis B (HBV) is a common cause of advanced liver disease and liver cancer. Liver transplantation is the most effective treatment, however, without ongoing antiviral therapy, HBV recurs in 80 percent of recipients. While the patient's immune system plays a critical role in both viral clearance and liver injury, the role of HBV-specific cellular immunity in liver transplant patients has been unclear.
Researchers, led by Chung Mau Lo, of The University of Hong Kong, set out to understand this immunity in patients with HBV who received a liver transplant. They examined HBV-specific CD4 T-cell immune response in 52 HBV patients who'd undergone liver transplantation. Forty of these patients had experienced HBV recurrence and 12 had not. They compared data from 63 people with HBV who had not undergone transplantation. Forty such patients had chronic HBV and 23 had self-limited infection.