Document Detail

Hepatitis D viremia following orthotopic liver transplantation involves a typical HDV virion with a hepatitis B surface antigen envelope.
MedLine Citation:
PMID:  9620349     Owner:  NLM     Status:  MEDLINE    
Patients receiving orthotopic liver transplantation (OLT) because of type D hepatitis frequently exhibit what appears to be an autonomous, or "isolated," hepatitis D virus (HDV) infection following the transplantation, with no evidence of hepatitis B virus (HBV) in the graft or in the serum. These observations have led to the hypothesis that HBV might not always be required for HDV infection, or that HDV could exist as a latent infection until rescued by HBV. Alternatively, an apparently autonomous HDV infection could be explained by coinfection of a small number of hepatocytes with both viruses following transplantation, with a very low level of HBV expression that supports low-level HDV propagation. Our results are consistent with the latter hypothesis. Sensitive polymerase chain reaction (PCR)-based analysis of HBV and HDV viremia in transplantation patients with HDV infection previously characterized as isolated showed that HDV viremia was not independent of HBV viremia. Additional analyses, including PCR amplification, buoyant density analysis in a CsCl gradient, and immunoprecipitation with monoclonal hepatitis B surface antigen antibodies (anti-HBs), indicated that the posttransplant HDV particle is typical: it contains full-length HDV RNA and an envelope of hepatitis B surface antigen (HBsAg) and is not different from that found during the acute and chronic stages of HDV superinfection or coinfection. Moreover, an experimental test of the first hypothesis in chimpanzees did not support the idea that HDV can persist for several weeks as an isolated, latent infection that can be rescued subsequently by HBV. The data indicate, therefore, that latent HDV infection is not a factor in OLT recipients. We conclude that the HDV virion in the posttransplantation setting is typical, and that HDV viremia following OLT requires the helper function of HBV infection.
A Smedile; J L Casey; P J Cote; M Durazzo; B Lavezzo; R H Purcell; M Rizzetto; J L Gerin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  27     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-06-30     Completed Date:  1998-06-30     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1723-9     Citation Subset:  IM    
Division of Molecular Virology and Immunology, Georgetown University Medical Center, Rockville, MD 20852, USA.
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MeSH Terms
Antigens, Viral / immunology*
Cross Reactions
Hepatitis B virus / immunology*
Hepatitis D / etiology,  virology*
Hepatitis Delta Virus / immunology*
Liver Transplantation / adverse effects*
Middle Aged
Viral Envelope Proteins / immunology
Viremia / etiology,  virology*
Grant Support
Reg. No./Substance:
0/Antigens, Viral; 0/Viral Envelope Proteins

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