Patterns of hepatitis delta virus reinfection and disease in liver transplantation

Antonio Ottobrelli, Alfredo Marzano, Antonina Smedile, Serafino Recchia, Mauro Salizzoni, Chantal Cornu, Monique Emanuelle Lamy, Jean Bernard Otte, Bernard De Hemptinne, Andre Geubel, Marco Grendele, Michele Colledan, Dinangelo Galmarini, Giovanni Marinucci, Cristina Di Giacomo, Salvatore Agnes, Ferruccio Bonino, Mario Rizzetto

Research output: Contribution to journalArticlepeer-review


Twenty-seven carriers of the hepatitis B surface antigen who underwent liver transplantation in Italy and Belgium for terminal Hepatitis delta virus (HDV) cirrhosis were investigated. In 22 of the patients, HDV infection recurred. Two patients died of coexisting HDV and hepatitis B virus (HBV) reactivation. Four patients who died of unrelated causes were found to have HDV without signs of HBV reactivation. Five patients (18%) cleared both HBV and HDV after transplantation with no evidence of hepatitis (mean follow-up, 29 months). In many surviving patients, HDV infection recurred early without signs of HBV reactivation. Disease returned in the 11 HDV-infected patients in whom HBV also recurred. Histological hepatitis did not recur during an interim of 12-33 months in the 5 HDV-infected patients in whom HBV did not return. The overall medium-term survival in patients with HDV who underwent transplantation was 77.7%. Liver transplantation offers patients with HDV a hope of cure from disease despite a high risk of reinfection. In the transplantation setting, HDV can cause subclinical infections without any apparent assistance from HBV; these infections become symptomatic only if and when HBV reactivates. Thus, HDV may not be in itself pathogenic but requires cooperation from HBV to cause the appearance of the disease.

Original languageEnglish
Pages (from-to)1649-1655
Number of pages7
Issue number6
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Gastroenterology


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