Fatal Reactivation of Precore Mutant Hepatitis B Virus Associated with Fibrosing Cholestatic Hepatitis after Bone Marrow Transplantation

Brief Communications15 August 1994Fatal Reactivation of Precore Mutant Hepatitis B Virus Associated with Fibrosing Cholestatic Hepatitis after Bone Marrow TransplantationCarolyn McIvor, FRACP, James Morton, MBBS, Andrew Bryant, FRACP, W. Graham Cooksley, FRACP, Simon Durrant, MRCP, and Neal Walker, FRACPCarolyn McIvor, FRACPFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia., James Morton, MBBSFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia., Andrew Bryant, FRACPFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia., W. Graham Cooksley, FRACPFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia., Simon Durrant, MRCPFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia., and Neal Walker, FRACPFrom the Royal Brisbane Hospital, Brisbane, Queensland, Australia.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-4-199408150-00007 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Liver failure caused by reactivation of hepatitis B virus (HBV) is an uncommon complication of bone marrow transplantation [1-3]. Fibrosing cholestatic hepatitis is a recently described liver lesion that develops after liver transplantation for chronic HBV infection. Hepatitis B virus precore mutant infection has been associated with liver failure after cytotoxic chemotherapy [4] and with fibrosing cholestatic hepatitis after liver transplantation [5, 6], but the relation is unclear. We describe a patient who developed fibrosing cholestatic hepatitis and HBV precore mutant infection after bone marrow transplantation.Case ReportA 49-year-old Chinese man had allogeneic bone marrow transplantation for acute myeloid ...References1. Chen PM, Fan S, Liu CJ, Hsieh RK, Liu JH, Chuang MW, et al. Changing of hepatitis B virus markers in patients with bone marrow transplantation. Transplantation. 1990; 49:708-13. Google Scholar2. Pariente EA, Goudeau A, Dubois F, Degott C, Gluckman E, Devergie A, et al. Fulminant hepatitis due to reactivation of chronic hepatitis B virus infection after allogeneic bone marrow transplantation. Dig Dis Sci. 1988; 33:1185-91. Google Scholar3. Webster A, Brenner MK, Prentice HG, Griffiths PD. Fatal hepatitis B reactivation after autologous bone marrow transplantation. Bone Marrow Transplant. 1989; 4:207-8. Google Scholar4. Yoshiba M, Sekiyama K, Sugata F, Okamoto H, Yamamoto K, Yotsumoto S. Reactivation of precore mutant hepatitis B virus leading to fulminant hepatic failure following cytotoxic treatment. Dig Dis Sci. 1992; 37:1253-9. Google Scholar5. Angus P, Richards M, Bowden S, Ireton J, Sinclair R, Jones R, et al. Combination antiviral therapy controls severe post-liver transplant recurrence of hepatitis B virus infection. J Gastroenterol Hepatol. 1993; 8:353-7. Google Scholar6. Fang JW, Tung FY, Davis GL, Dolson DJ, Van Thiel DH, Lau JY. Fibrosing cholestatic hepatitis in a transplant recipient with hepatitis B virus precore mutant. Gastroenterology. 1993; 105:901-4. Google Scholar7. Carman WF, Jacyna MR, Hadziyannis S, Karayiannis P, McGarvey MJ, Makris A, et al. Mutation preventing formation of hepatitis B e antigen in patients with chronic hepatitis B infection. Lancet. 1989; 2:588-91. Google Scholar8. Locasciulli A, Bacigalupo A, Van Lint MT, Chemello L, Pontisso P, Occhini D, et al. Hepatitis B virus (HBV) infection and liver disease after allogeneic bone marrow transplantation: a report of 30 cases. Bone Marrow Transplant. 1990; 6:25-9. Google Scholar9. Reed EC, Myerson D, Corey L, Meyers JD. Allogeneic marrow transplantation in patients positive for hepatitis B surface antigen. Blood. 1991; 77:195-200. Google Scholar10. Ilan Y, Nagler A, Adler R, Naparstek E, Or R, Slavin S, et al. Adoptive transfer of immunity to hepatitis B virus after T cell-depleted allogeneic bone marrow transplantation. Hepatology. 1993; 18:246-52. Google Scholar Author, Article, and Disclosure InformationAuthors: Carolyn McIvor, FRACP; James Morton, MBBS; Andrew Bryant, FRACP; W. Graham Cooksley, FRACP; Simon Durrant, MRCP; Neal Walker, FRACPAffiliations: From the Royal Brisbane Hospital, Brisbane, Queensland, Australia.Corresponding Author: W. Graham Cooksley, MD, Clinical Research Centre, H Floor, Bancroft Center, Royal Brisbane Hospital, 300 Herston Road, Brisbane, Queensland 4029, Australia.Grant Support: In part by a Gastroenterological Society of Australia Medical Postgraduate Scholarship and by the Royal Brisbane Hospital Research Foundation. 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Doesn't CMV activation and/or a graft-versus-host component of the disease, also have to be considered? I. First of two partsHEPATITIS B AND TRANSPLANTATIONFibrosing cholestatic hepatitis and HBV after bone marrow transplantation 15 August 1994Volume 121, Issue 4Page: 274-275KeywordsAntigensBone marrow transplantationDNAHepatitis AHepatitis BHepatitis B virusLiverLiver diseasesLiver transplantationTransplantation ePublished: 15 August 2000 Issue Published: 15 August 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...