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Resumen
Un varón de 47 años se sometió a un trasplante hepático por cirrosis hepática alcohólica. A los 15 meses se le diagnosticó de hepatitis B de novo. Las serologías realizadas durante el seguimiento revelaron una negatividad persistente del anticuerpo frente al antígeno core del virus de la hepatitis B que se mantuvo durante 20 meses. Se revisan las causas de la negatividad de dicho anticuerpo. El papel de la inmunodepresión se debe tener en cuenta en casos similares.
De novo hepatitis B was diagnosed in a 47-year-old man 15 months after liver transplantation for end-stage alcoholic cirrhosis. Serum antibodies to hepatitis B core antigen (anti- HBc) were negative, and remained undetectable over 20 months of follow-up. The possible causes of negative serum anti-HBc despite of active hepatitis B virus infection are reviewed. Immunosuppression may underlie this phenomenon in similar cases.
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Bibliografía
[1.]
R.C. Dickson, J.E. Everhart, J.R. Lake, Y. Wei, E.C. Seaberg, R.H. Wiesner, et al.
Transmission of hepatitis B by transplantation of livers from donors positive for antibody to hepatitis B core antigen.
Gastroenterology, 113 (1997), pp. 1668-1674
[2.]
S. Uemoto, K. Sugiyama, H. Marusawa, Y. Inomata, K. Asonuma, H. Egawa, et al.
Transmission of hepatitis B virus from hepatitis B core antibody-positive donors in living-related liver transplant.
Transplantation, 65 (1998), pp. 494-499
[3.]
M. Wachs, W. Amend, N. Ascher, P. Bretan, J. Emond, J. Lake, et al.
The risk of transmission of hepatitis B from HBsAg(–), HBcAg(+), HBIgM(–) organ donors.
Transplantation, 59 (1995), pp. 230-234
[5.]
R. Fabia, M.F. Levy, J. Crippin, W. Tillery, G.J. Netto, J. Aguanno, et al.
De novo hepatitis B infection after liver transplantation: source of disease, incidence and impact.
Liver Transpl Surg, 4 (1998), pp. 119-127
[6.]
M. Prieto, M.D. Gómez, M. Berenguer, J. Córdoba, J.M. Rayon, M. Pastor, et al.
De novo hepatitis B after liver transplantation from hepatitis B core antibody-positive donors in an area with high prevalence of anti-HBc positivity in the donor population.
Liver Transplantation, 7 (2001), pp. 51-58
[7.]
A.M. Courouce, J. Drouet, N. Le Marrec, A. Drouet, J.P. Soulier.
Blood donors positive for HBsAg and negative for anti-HBc antibody.
Vox Sang, 49 (1985), pp. 26-33
[8.]
S. Laperche, C. Guitton, W. Smilovici, A.M. Courouce.
Blood donors infected with the hepatitis B virus but persistently lacking antibodies to the hepatitis B core antigen.
Vox Sang, 80 (2001), pp. 90-94
[9.]
V. Vranckx, L. Muylle, A. Meheus.
Hepatitis B core antibodynegative HBsAg carriers.
Infection, 17 (1989), pp. 250-251
[10.]
T. Terada, M. Moriyama, T. Uchida, Y. Arakawa.
Nucleotide sequence of the precore/core gene and X gene of hepatitis B virus DNA in asymptomatic hepatitis B virus carriers who are negative for serum hepatitis B core antibody.
Intervirology, 44 (2001), pp. 243-249
[11.]
Y. Lazizi, P. Dubreuil, J. Pillot.
Excess HBcAg in HBc antibodynegative chronic hepatitis B virus carriers.
Hepatology, 17 (1993), pp. 966-970
[12.]
B. Möller, U. Hopf, R. Stermerowicz, G. Henze, H. Gelderblom.
HBcAg expressed on the surface of circulating Dane particles in patients wit hepatitis B virus infection without evidence of anti-HBc formation.
Hepatology, 10 (1989), pp. 179-185
[13.]
R.A. Bhat, P.P. Ulrich, G.N. Vyas.
Molecular characterization of a new variant of hepatitis B virus in a persistently infected homosexual man.
Hepatology, 11 (1990), pp. 271-276
[14.]
S.D. Lee, K.J. Lo, Y.T. Tsai, J.C. Wu, T.C. Wu.
HBsAg carrier infants with serum anti-HBc negativity.
Hepatology, 9 (1989), pp. 102-104
[15.]
K. Gotoh, S. Mima, T. Uchida, T. Shikata, K. Yoshizawa, M. Irie, et al.
Nucleotide sequence of hepatitis B virus isolated from subjects without serum anti-hepatitis B core antibody.
J Med Virol, 46 (1995), pp. 201-206
[16.]
J.H. Lee, T.G. Paglieroni, P.V. Holland, J.B. Zeldis.
Chronic hepatitis B virus infection in an anti-HBc-nonreactive blood donor: variant virus or defective immune response?.
Hepatology, 16 (1992), pp. 24-30
[17.]
G. Fiordalisi, D. Primi, E. Tanzi, E. Magni, C. Incarbone, A.R. Zanetti, et al.
Hepatitis B virus C gene heterogeneity in a familial cluster of anti-HBc negative chronic carriers.
J Med Virol, 42 (1994), pp. 109-114
[18.]
H.J. Hsu, M.H. Chang, K.H. Hseih, C.Y. Lee, H.N. Lin, L.H. Hwang, et al.
Cellular immune response to HBcAg in mother-to-infant transmission of hepatitis B virus.
Hepatology, 15 (1992), pp. 770-776
[19.]
M. Melegari, M.C. Jung, R. Schneider, T. Santantonio, S. Bagnulo, N. Luchena, et al.
Conserved core protein sequences in hepatitis B virus infected patients without antibody to HBc.
Hepatology, 13 (1991), pp. 187-191
[20.]
F. Zoulim, X. Zhang, C. Pichoud, C. Trepo.
Heterogeneity of hepatitis B virus (HBV) core gene in a patient with HBV-associated cirrhosis and serum negativity for anti-HBc.
J Hepatol, 24 (1996), pp. 155-160
[21.]
D. Vergani, G. Masera, G. Moroni, B. Portmann, A. Locasciulli, A. Alberti, et al.
Histological evidence of hepatitis B virus infection with negative serology in children with acute leukemia who develop chronic liver disease.
Lancet, 1 (1982), pp. 361-364
[22.]
P. Coursaget, B. Yvonnet, C. Bourdil, M.N. Mevelec, P. Adamonwicz, J.L. Barres, et al.
HBsAg positive reactivity in man not due to hepatitis B virus.
Lancet, 2 (1987), pp. 1354-1358
[23.]
J.H. Hoofnagle, R.J. Gerety, L.F. Barker.
Antibody to hepatitis-Bvirus core in man.
Lancet, 2 (1973), pp. 869-873
[24.]
L.B. Seeff, G.W. Beebe, J.H. Hoofnagle, J.E. Norman, Z. Buskell-Bales, J.G. Waggoner, et al.
A serological follow-up of the 1942 epidemic of post vaccination hepatitis in the United States army.
N Engl J Med, 316 (1987), pp. 965-970
[26.]
J.M. Echevarría, P. León, C.J. Domingo, J.A. López, J.E. Echevarría, G. Contreras, et al.
Characterization of the HBV2-like infection in Spain.
J Med Virol, 33 (1991), pp. 240-247
[27.]
D.R. Milich, J.E. Jones, J.L. Hughes, J. Price, A.K. Raney, A. McLachlan.
Is a function of the secreted hepatitis B e antigen to induce immunologic tolerance in utero?.
Proc Natl Acad Sci USA, 87 (1990), pp. 6599-6603
[28.]
A. Cavallari, E. De Raffele, R. Bellusci, R. Miniero, M. Vivarelli, S. Galli, et al.
De novo hepatitis B and C viral infection after liver transplantation.
World J Surg, 21 (1997), pp. 78-85
[29.]
B. Roche, D. Samuel, M. Gigou, C. Feray, V. Virot, L. Schmets, et al.
De novo and apparent de novo hepatitis B virus infection after liver transplantation.
J Hepatol, 26 (1997), pp. 517-526
[30.]
R. Segovia, A. Sánchez-Fueyo, A. Rimola, L. Grande, M. Bruguera, J. Costa, et al.
Evidence of serious graft damage induced by de novo hepatitis B virus infection after liver transplantation.
Liver Transpl, 7 (2001), pp. 106-112
[31.]
J. Crespo, E. Fabrega, F. Casafont, M. Rivero, G. de las Heras, J de la Peña, et al.
Severe clinical course of de novo hepatitis B infection after liver transplantation.
Liver Transpl Surg, 5 (1999), pp. 175-183
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