TY - JOUR
T1 - Hepatitis B infection in patients with acute liver failure in the United States
AU - Teo, Eng Kiong
AU - Ostapowicz, George
AU - Hussain, Munira
AU - Lee, William M.
AU - Fontana, Robert J.
AU - Lok, Anna S.F.
AU - Lee, William M.
AU - Larson, Anne
AU - Caldwell, C.
AU - Peters, Marion
AU - Shick, Lawton
AU - Bass, Nathan
AU - Davern, Tim
AU - Rouillard, Smita
AU - Atillasoy, Evren
AU - McCashland, Tim
AU - Hay, J. Eileen
AU - Wiesner, Russell
AU - Crippin, Jeffrey
AU - Shakil, A. Obaid
AU - Flamm, Steven
AU - Benner, Kent
AU - Han, Steven Hb
AU - Martin, Paul
AU - Stribling, Rise
AU - Schiff, Eugene
AU - Torres, Maria
AU - Fontana, Robert
N1 - Funding Information:
Abbreviations: ALF, acute liver failure; HBsAg, hepatitis B surface antigen; anti-HBc IgM, hepatitis B core antibody immunoglobulin M; HBV, hepatitis B virus; PCR, polymerase chain reaction; HBeAg, hepatitis B e antigen. From the 1University of Michigan Medical Center, Ann Arbor, MI; and 2University of Texas Southwestern Medical Center, Dallas, TX. Received October 6, 2000; accepted January 11, 2001. Supported by NIH grant R03 DL52827-01 (to W.M.L.) and a VA Merit Award (to A.S.F.L). Address reprint requests to: Anna S. F. Lok, M.D., Division of Gastroenterology, University of Michigan Medical Center, 3912 Taubman Center, Box 0362, Ann Arbor, MI 48109. E-mail: [email protected]; fax: 734-936-7392. Copyright © 2001 by the American Association for the Study of Liver Diseases. 0270-9139/01/3304-0026$35.00/0 doi:10.1053/jhep.2001.23065
PY - 2001
Y1 - 2001
N2 - Occult hepatitis B virus (HBV) infection has been reported in 30% to 50% of patients with acute liver failure (ALF) in small case series. The aim of this study was to determine the prevalence of occult HBV infection in a large series of ALF patients in the United States and the prevalence of precore and core promoter variants in patients with ALF caused by hepatitis B. Sera from patients in the US ALF study and liver, when available, were tested using nested polymerase chain reaction (PCR) with primers in the HBV S and precore regions. PCR-positive samples were sequenced. Sera and/or liver from 139 patients (39 males, 100 females; mean age, 42 years) enrolled between January 1998 and December 1999 were studied. Twelve patients were diagnosed with hepatitis B, 1 with hepatitis B+C+D coinfection, and 22 had indeterminate etiology. HBV DNA was detected in the sera of 9 (6%) patients; all 9 had ALF caused by hepatitis B. HBV genotypes A, B, C, and D were present in 4, 3, 1, and 1 patients, respectively. Seven of these 9 patients had precore and/or core promoter variants. Liver from 19 patients were examined. HBV DNA was detected in the liver of 3 patients with ALF caused by hepatitis B, but in none of the remaining 16 patients with non-B ALF. Contrary to earlier reports, occult HBV infection was not present in this large series of ALF patients in the United States. HBV precore and/or core promoter variants were common among US patients with ALF caused by hepatitis B.
AB - Occult hepatitis B virus (HBV) infection has been reported in 30% to 50% of patients with acute liver failure (ALF) in small case series. The aim of this study was to determine the prevalence of occult HBV infection in a large series of ALF patients in the United States and the prevalence of precore and core promoter variants in patients with ALF caused by hepatitis B. Sera from patients in the US ALF study and liver, when available, were tested using nested polymerase chain reaction (PCR) with primers in the HBV S and precore regions. PCR-positive samples were sequenced. Sera and/or liver from 139 patients (39 males, 100 females; mean age, 42 years) enrolled between January 1998 and December 1999 were studied. Twelve patients were diagnosed with hepatitis B, 1 with hepatitis B+C+D coinfection, and 22 had indeterminate etiology. HBV DNA was detected in the sera of 9 (6%) patients; all 9 had ALF caused by hepatitis B. HBV genotypes A, B, C, and D were present in 4, 3, 1, and 1 patients, respectively. Seven of these 9 patients had precore and/or core promoter variants. Liver from 19 patients were examined. HBV DNA was detected in the liver of 3 patients with ALF caused by hepatitis B, but in none of the remaining 16 patients with non-B ALF. Contrary to earlier reports, occult HBV infection was not present in this large series of ALF patients in the United States. HBV precore and/or core promoter variants were common among US patients with ALF caused by hepatitis B.
UR - http://www.scopus.com/inward/record.url?scp=17744387699&partnerID=8YFLogxK
U2 - 10.1053/jhep.2001.23065
DO - 10.1053/jhep.2001.23065
M3 - Article
C2 - 11283862
AN - SCOPUS:17744387699
SN - 0270-9139
VL - 33
SP - 972
EP - 976
JO - Hepatology
JF - Hepatology
IS - 4
ER -