De novo infection of hepatitis B virus in patients with orthotopic liver transplantation: Analysis by determining complete sequence of the genome

De novo infection of hepatitis B virus (HBV) occurs after liver transplanta tion from donors with HBV markers that suggest past infection. In the prese nt study, the complete nucleotide sequences of HBV derived from a donor and recipients were determined to determine the clinical and virological chara cteristics. A total of 57 donor-recipient pairs, which underwent living-rel ated orthotopic liver transplantation, were enrolled in the present study; all were negative for HBsAg before transplantation. HBV DNA was tested in s erum, liver tissue, and peripheral blood mononuclear cells (PBMCs) by the p olymerase chain reaction (PCR). The nucleotide sequence of HBV was determin ed based on PCR products and the phylogenetic analysis. De novo infection o f HBV was found in 3 of the 57 recipients. Anti-HBc was positive in all don ors of 3 recipients with the de novo infection but was positive only in 4 d onors of the remaining 54 recipients (P=0.001). HBV DNA was detected in the liver but not in the serum or PBMCs in donor 3 whose recipient developed d e novo HBV infection. The nucleotide sequence covering entire genome of HBV (3,215 bases) derived from the liver of donor 3 had a homology of 99.8-100 % with that derived from the serum of corresponding recipient 3. The strain of recipient 3 showed the closest association with that of the donor 3 by phylogenetic analysis. Complete sequences from two recipients with de novo HBV infection including recipient 3 conserved the basic organisation of HBV genome. Analysis of the entire nucleotide sequence of HBV genome proved th at HBV existed in the liver of the donor with anti-HBc, and it caused de no vo infection in the corresponding recipient. J. Med. Virol. 62:471-478, 200 0. (C) 2000 Wiley-Liss, Inc.