Does OKT3 increase the risk of recurrent hepatitis B in patients transplanted for hepatitis B?

The aim of this work was to analyze whether the treatment of acute rejectio n of orthotopic liver transplants (OLT), either with corticoids or OKT3, ha s any effect on levels of hepatitis B virus (HBV)-DNA and HbsAg in individu als which were originally affected by cirrhosis or fulminant hepatic failur e as a result of B virus. We have found that HBV-DNA is present in macropha ges, B cells and both CD4+ and CD8+ T cells after OLT in all cases studied Interestingly, the levels of HBV-DNA and HbsAg in the serum analyzed were i ncreased extremely rapidly in the patients treated with OKT3 in an acute re jection episode. However, the serum levels of HBV-DNA and HbsAg found were lower when the patients were treated with steroids, and were not found in n on-treated patients. As the serum levels of HBV-DNA increase, the process o f liver reinfection could be accelerated; therefore, these results may help to understand how OKT3 and corticoids immunosuppressive therapy may accele rate the reinfection of OLT by HBV. In conclusion, our results suggest that special care must be taken in the use of OKT3 in the treatment of acute li ver rejection episodes in chronic or fulminant HBV transplanted patients.