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Semin Liver Dis 2012; 32(03): 245-255
DOI: 10.1055/s-0032-1323630
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Liver Transplantation in Delta Virus Infection

Bruno Roche
1   Assistance Publique-Hopitaux de Paris, Hopital Paul Brousse, Centre Hepato-Biliaire, Villejuif, France
2   INSERM, U785, Villejuif, France
3   Univ Paris-Sud, UMR-S785 Villejuif, France
,
Didier Samuel
1   Assistance Publique-Hopitaux de Paris, Hopital Paul Brousse, Centre Hepato-Biliaire, Villejuif, France
2   INSERM, U785, Villejuif, France
3   Univ Paris-Sud, UMR-S785 Villejuif, France
› Author Affiliations
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Publication History

Publication Date:
29 August 2012 (online)

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Abstract

Liver transplantation is the only therapy for patients with end-stage liver disease, hepatocellular carcinoma, or fulminant hepatitis due to hepatitis D virus (HDV) and hepatitis B virus (HBV) coinfection or superinfection. Patients chronically coinfected with HDV are less at risk of HBV recurrence and have a better survival rate than patients infected with HBV alone. Patients coinfected with HDV generally do not require pretransplant antiviral therapy. Rates of recurrent HBV-HDV infection are lower than 5% using low-dose intramuscular (IM) HBIg and antiviral prophylaxis in combination. Few studies have evaluated the possibility of using shorter-term HBIg (12–24 months) then switching to antiviral therapy. Although HBV replication can be controlled by potent HBV-polymerase inhibitors, reappearance of HBsAg and/or the persistence of HBV DNA in serum, liver, or peripheral blood mononuclear cells might have deleterious consequences in the setting of HBV-HDV coinfection as they may provide the biologic substrate to the reactivation of HDV. No effective antiviral drug is available for the treatment of graft infection with HDV.

Keywords

Hepatitis Delta liver transplantation - Hepatitis B immune globulins - HBV antiviral drugs