FIBROSING CHOLESTATIC HEPATITIS IN A RENAL-TRANSPLANT RECIPIENT ASSOCIATED WITH THE HEPATITIS-B VIRUS PRECORE MUTANT

A patient with evidence of chronic infection with hepatitis B virus (s eropositive for hepatitis B surface antigen, and with antibody to hepa titis B e antigen) underwent renal transplantation, which subsequently failed. The patient developed abnormal liver function tests and 8 mon ths after the removal of the transplanted kidney, hepatitis B virus DN A was detected in the serum in the absence of hepatitis B e antigen, L iver biopsy revealed the presence of fibrosing cholestatic hepatitis. Sequence analysis of the serum hepatitis B virus DNA showed, the prese nce of the pre-core mutant. This case shows that fibrosing cholestatic hepatitis can occur outside the setting of liver transplantation, and coincided with the development of the pre-core mutant of hepatitis B virus.