Hepatitis B and Hepatitis D Infections in the Transplant Setting

Living reference work entry


Hepatitis B virus (HBV) and hepatitis D virus (HDV) are hepatotropic viruses that can have a significant impact on patients undergoing solid organ and hematopoietic stem cell transplants. In the setting of transplant immunosuppression, patients with HBV or HDV coinfection can have acceleration in the natural history of their liver diseases with increased risk of developing cirrhosis, decompensation, and hepatocellular carcinoma. Immunosuppression can also reactivate HBV in patients with previous immune control. Moreover, with the national organ shortage and worsening opioid epidemic, increasing rise in donor transmission and de novo HBV can be expected. Appropriate screening, vaccination, prophylaxis, and treatment of those patients at risk for these potential complications can have a great impact on their post-transplant outcomes. Management of HBV and HDV can be complex and depends on the type of organ transplant, degree of immunosuppression, and donor/recipient HBV exposure/immune status. This process of evaluation and management starts before the transplant event with serologic screening of donors and recipients and pre-transplant vaccination of susceptible recipients, and it continues well after transplant with close monitoring and careful consideration of antiviral prophylaxis and treatment. If done successfully, outcomes of patients at risk for HBV complications can be similar to those without HBV.


Cirrhosis Hepatocellular carcinoma HBsAg Reactivation de nove hepatitis B Transmission 


  1. 1.
    Goldstein ST, Zhou F, Hadler SC, et al. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol. 2005;34:1329–39.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Schweitzer A, Horn J, Mikolajczyk RT, et al. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015;386:1546–55.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Liaw YF. Natural history of chronic hepatitis B virus infection and long-term outcome under treatment. Liver Int. 2009;29(Suppl 1):100–7.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Abbas Z, Jafri W, Raza S. Hepatitis D: scenario in the Asia-Pacific region. World J Gastroenterol. 2010;16:554–62.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Rizzetto M, Hepatitis D. Virus: introduction and epidemiology. Cold Spring Harb Perspect Med. 2015;5:a021576.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ghany MG, Perrillo R, Li R, et al. Characteristics of adults in the hepatitis B research network in North America reflect their country of origin and hepatitis B virus genotype. Clin Gastroenterol Hepatol. 2015;13:183–92.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Harris AM, Iqbal K, Schillie S, et al. Increases in acute hepatitis B virus infections – Kentucky, Tennessee, and West Virginia, 2006–2013. MMWR Morb Mortal Wkly Rep. 2016;65:47–50.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Flemming JA, Kim WR, Brosgart CL, et al. Reduction in liver transplant wait-listing in the era of direct-acting antiviral therapy. Hepatology. 2017;65:804–12.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Kim WR, Terrault NA, Pedersen RA, et al. Trends in waiting list registration for liver transplantation for viral hepatitis in the United States. Gastroenterology. 2009;137:1680–6.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Chopra B, Sureshkumar KK. Outcomes of kidney transplantation in patients exposed to hepatitis B virus: analysis by phase of infection. Transplant Proc. 2017;49:278–80.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Maini MK, Gehring AJ. The role of innate immunity in the immunopathology and treatment of HBV infection. J Hepatol. 2016;64:S60–70.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Bertoletti A, Ferrari C. Adaptive immunity in HBV infection. J Hepatol. 2016;64:S71–83.CrossRefGoogle Scholar
  13. 13.
    Zhou K, Contag C, Whitaker E, et al. Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses. Lancet Gastroenterol Hepatol. 2019;4:227–38.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Yeo YH, Ho HJ, Yang HI, et al. Factors associated with rates of HBsAg seroclearance in adults with chronic HBV infection: a systematic review and meta-analysis. Gastroenterology. 2019;156:635–46.. e9CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Xia Y, Liang TJ. Development of direct-acting antiviral and host-targeting agents for treatment of hepatitis B virus infection. Gastroenterology. 2019;156:311–24.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ji M, Hu K. Recent advances in the study of hepatitis B virus covalently closed circular DNA. Virol Sin. 2017;32:454–64.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Terrault NA, Lok AS, McMahon BJ, et al. Update on prevention, diagnosis, and treatment and of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67:1560–99.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Peng CY, Chien RN, Liaw YF. Hepatitis B virus-related decompensated liver cirrhosis: benefits of antiviral therapy. J Hepatol. 2012;57:442–50.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Singal AK, Salameh H, Kuo YF, et al. Meta-analysis: the impact of oral anti-viral agents on the incidence of hepatocellular carcinoma in chronic hepatitis B. Aliment Pharmacol Ther. 2013;38:98–106.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Marzano A, Gaia S, Ghisetti V, et al. Viral load at the time of liver transplantation and risk of hepatitis B virus recurrence. Liver Transpl. 2005;11:402–9.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Mohan D, Railey M, Al Rukhaimi M. Vaccination and transient hepatitis B surface antigenemia. NDT Plus. 2011;4:190–1.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Raimondo G, Pollicino T, Cacciola I, et al. Occult hepatitis B virus infection. J Hepatol. 2007;46:160–70.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Benwell N, Boan P, Raby E, et al. False positive hepatitis B virus core and surface antibodies due to intravenous immunoglobulin. Intern Med J. 2017;47:119–20.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Seed CR, Allain JP, Lozano M, et al. International forum on occult hepatitis B infection and transfusion safety. Vox Sang. 2019;114(4):397–406.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Organ Procurement and Transplant Network (OPTN). Policies. 2019. Available from: Effective Date March 1, 2019. Dated Accessed 9 Mar 2019. 2019.
  26. 26.
    Huprikar S, Danziger-Isakov L, Ahn J, et al. Solid organ transplantation from hepatitis B virus-positive donors: consensus guidelines for recipient management. Am J Transplant. 2015;15:1162–72.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Bixler D, Annambholta P, Abara WE, et al. Hepatitis B and C virus infections transmitted through organ transplantation investigated by CDC, United States, 2014–2017. Am J Transplant. 2019;19(9):2570–82.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Abara WE, Collier MG, Moorman A, et al. Characteristics of deceased solid organ donors and screening results for hepatitis B, C, and human immunodeficiency viruses – United States, 2010–2017. MMWR Morb Mortal Wkly Rep. 2019;68:61–6.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Malinis M, Boucher HW, Practice ASTIDCo. Screening of donor and candidate prior to solid organ transplantation – guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transpl. 2019;33(9):e13548.CrossRefGoogle Scholar
  30. 30.
    Millonig G, Friedrich S, Adolf S, et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol. 2010;52:206–10.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Del Poggio P, Colombo S. Is transient elastography a useful tool for screening liver disease? World J Gastroenterol. 2009;15:1409–14.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Liang XE, Zhong C, Huang L, et al. Optimization of hepatitis B cirrhosis detection by stepwise application of transient elastography and routine biomarkers. J Gastroenterol Hepatol. 2017;32:459–65.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Liaw YF, Pao CC, Chu CM. Changes of serum HBV-DNA in relation to serum transaminase level during acute exacerbation in patients with chronic type B hepatitis. Liver. 1988;8:231–5.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Karvellas CJ, Cardoso FS, Gottfried M, et al. HBV-associated acute liver failure after immunosuppression and risk of death. Clin Gastroenterol Hepatol. 2017;15:113–22.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Fornairon S, Pol S, Legendre C, et al. The long-term virologic and pathologic impact of renal transplantation on chronic hepatitis B virus infection. Transplantation. 1996;62:297–9.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Fabrizi F, Martin P, Dixit V, et al. HBsAg seropositive status and survival after renal transplantation: meta-analysis of observational studies. Am J Transplant. 2005;5:2913–21.CrossRefGoogle Scholar
  37. 37.
    Starzl TE, Demetris AJ, Van Thiel D. Liver transplantation (2). N Engl J Med. 1989;321:1092–9.CrossRefGoogle Scholar
  38. 38.
    Todo S, Demetris AJ, Van Thiel D, et al. Orthotopic liver transplantation for patients with hepatitis B virus-related liver disease. Hepatology. 1991;13:619–26.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Samuel D, Muller R, Alexander G, et al. Liver transplantation in European patients with the hepatitis B surface antigen. N Engl J Med. 1993;329:1842–7.CrossRefGoogle Scholar
  40. 40.
    Davies S, Portmann B, O'Grady J, et al. Hepatic histological findings after transplantation for chronic hepatitis B virus infection, including a unique pattern of fibrosing cholestatic hepatitis. Hepatology. 1991;13:150–7.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Mason A, Wick M, White H, et al. Increased hepatocyte expression of hepatitis B virus transcription in patients with features of fibrosing cholestatic hepatitis. Gastroenterology. 1993;105:237–44.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Mathurin P, Mouquet C, Poynard T, et al. Impact of hepatitis B and C virus on kidney transplantation outcome. Hepatology. 1999;29:257–63.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Lee J, Cho JH, Lee JS, et al. Pretransplant hepatitis B viral infection increases risk of death after kidney transplantation: a multicenter cohort study in Korea. Medicine (Baltimore). 2016;95:e3671.CrossRefGoogle Scholar
  44. 44.
    Yap DY, Tang CS, Yung S, et al. Long-term outcome of renal transplant recipients with chronic hepatitis B infection-impact of antiviral treatments. Transplantation. 2010;90:325–30.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Harmanci O, Ilin S, Ocal S, et al. The effect of hepatitis B virus on graft and overall survival in kidney transplant patients. Exp Clin Transplant. 2015;13(Suppl 3):36–40.PubMedPubMedCentralGoogle Scholar
  46. 46.
    Chen YC, Chuang MK, Chou NK, et al. Twenty-four year single-center experience of hepatitis B virus infection in heart transplantation. Transplant Proc. 2012;44:910–2.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Hoffmann CJ, Subramanian AK, Cameron AM, et al. Incidence and risk factors for hepatocellular carcinoma after solid organ transplantation. Transplantation. 2008;86:784–90.CrossRefPubMedPubMedCentralGoogle Scholar
  48. 48.
    Gentile G, Andreoni M, Antonelli G, et al. Screening, monitoring, prevention, prophylaxis and therapy for hepatitis B virus reactivation in patients with haematologic malignancies and patients who underwent haematologic stem cell transplantation: a systematic review. Clin Microbiol Infect. 2017;23:916–23.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Lau GK, Leung YH, Fong DY, et al. High hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation. Blood. 2002;99:2324–30.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Lau GK, Yiu HH, Fong DY, et al. Early is superior to deferred preemptive lamivudine therapy for hepatitis B patients undergoing chemotherapy. Gastroenterology. 2003;125:1742–9.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Sarmati L, Andreoni M, Antonelli G, et al. Recommendations for screening, monitoring, prevention, prophylaxis and therapy of hepatitis B virus reactivation in patients with haematologic malignancies and patients who underwent haematologic stem cell transplantation-a position paper. Clin Microbiol Infect. 2017;23:935–40.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Knoll A, Pietrzyk M, Loss M, et al. Solid-organ transplantation in HBsAg-negative patients with antibodies to HBV core antigen: low risk of HBV reactivation. Transplantation. 2005;79:1631–3.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Querido S, Weigert A, Adragao T, et al. Risk of hepatitis B reactivation in hepatitis B surface antigen seronegative and core antibody seropositive kidney transplant recipients. Transpl Infect Dis. 2019;21:e13009.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Abdelmalek M, Pasha T, Zein N, et al. Subclinical reactivation of hepatitis B virus in liver transplant recipients with past exposure. Liver Transpl. 2003;9:1253–7.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Buti M, Gane E, Seto WK, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of patients with HBeAg-negative chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial. Lancet Gastroenterol Hepatol. 2016;1:196–206.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Chan HL, Fung S, Seto WK, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate for the treatment of HBeAg-positive chronic hepatitis B virus infection: a randomised, double-blind, phase 3, non-inferiority trial. Lancet Gastroenterol Hepatol. 2016;1:185–95.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Tenney DJ, Rose RE, Baldick CJ, et al. Long-term monitoring shows hepatitis B virus resistance to entecavir in nucleoside-naive patients is rare through 5 years of therapy. Hepatology. 2009;49:1503–14.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Park ES, Lee AR, Kim DH, et al. Identification of a quadruple mutation that confers tenofovir resistance in chronic hepatitis B patients. J Hepatol. 2019;70(6):1093–102.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Magnone M, Holley J, Shapiro R, et al. Interferon-a-induced acute renal allograft rejection. Transplantation. 1995;59:1068–70.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Baid S, Tolkoff-Rubin N, Saidman S, et al. Acute humoral rejection in hepatitis C-infected renal transplant recipients receiving antiviral therapy. Am J Transplant. 2003;3:74–8.CrossRefPubMedPubMedCentralGoogle Scholar
  61. 61.
    Rangel MC, Coronado VG, Euler GL, et al. Vaccine recommendations for patients on chronic dialysis. The Advisory Committee on Immunization Practices and the American Academy of Pediatrics. Semin Dial. 2000;13:101–7.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Feuerhake A, Muller R, Lauchart W, et al. HBV-vaccination in recipients of kidney allografts. Vaccine. 1984;2:255–6.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Carey W, Pimentel R, Westveer MK, et al. Failure of hepatitis B immunization in liver transplant recipients: results of a prospective trial. Am J Gastroenterol. 1990;85:1590–2.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58:e44–100.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Schillie S, Harris A, Link-Gelles R, et al. Recommendations of the Advisory Committee on Immunization Practices for use of a hepatitis B vaccine with a novel adjuvant. MMWR Morb Mortal Wkly Rep. 2018;67:455–8.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Terrault NA, Zhou S, Combs C, et al. Prophylaxis in liver transplant recipients using a fixed dosing schedule of hepatitis B immunoglobulin. Hepatology. 1996;24:1327–33.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Samuel D, Bismuth A, Mathieu D, et al. Passive immunoprophylaxis after liver transplantation in HBsAg-positive patients. Lancet. 1991;337:813–5.CrossRefPubMedPubMedCentralGoogle Scholar
  68. 68.
    Khemichian S, Hsieh MJ, Zhang SR, et al. Nucleoside-nucleotide analog combination therapy is effective in preventing recurrent hepatitis B after liver transplantation. Dig Dis Sci. 2015;60:2807–12.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Fung J, Wong T, Chok K, et al. Long term outcomes of entecavir monotherapy for chronic hepatitis B after liver transplantation: results up to 8 years. Hepatology. 2017;66(4):1036–44.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Gane EJ, Patterson S, Strasser SI, et al. Combination of lamivudine and adefovir without hepatitis B immune globulin is safe and effective prophylaxis against hepatitis B virus recurrence in hepatitis B surface antigen-positive liver transplant candidates. Liver Transpl. 2013;19:268–74.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Radhakrishnan K, Chi A, Quan DJ, et al. Short course of postoperative hepatitis B immunoglobulin plus antivirals prevents reinfection of liver transplant recipients. Transplantation. 2017;101:2079–82.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Fox AN, Terrault NA. Individualizing hepatitis B infection prophylaxis in liver transplant recipients. J Hepatol. 2011;55:507–9.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Coffin CS, Stock PG, Dove LM, et al. Virologic and clinical outcomes of hepatitis B virus infection in HIV-HBV coinfected transplant recipients. Am J Transplant. 2010;10:1268–75.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Wachs M, Amend W, Ascher N, et al. The risk of transmission of hepatitis B from HBsAg(−), HBcAb(+), HBIgM(−) organ donors. Transplantation. 1995;59:230–4.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Skagen CL, Jou JH, Said A. Risk of de novo hepatitis in liver recipients from hepatitis-B core antibody-positive grafts – a systematic analysis. Clin Transpl. 2011;25:E243–9.CrossRefGoogle Scholar
  76. 76.
    Yen RD, Bonatti H, Mendez J, et al. Case report of lamivudine-resistant hepatitis B virus infection post liver transplantation from a hepatitis B core antibody donor. Am J Transplant. 2006;6:1077–83.CrossRefPubMedPubMedCentralGoogle Scholar
  77. 77.
    Cholongitas E, Papatheodoridis GV, Burroughs AK. Liver grafts from anti-hepatitis B core positive donors: a systematic review. J Hepatol. 2010;52:272–9.CrossRefPubMedPubMedCentralGoogle Scholar
  78. 78.
    Wong TC, Fung JY, Yu-Shi Cui T, et al. Liver transplantation using hepatitis B core positive grafts with antiviral monotherapy prophylaxis. J Hepatol. 2019;70(6):1114–22.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Mahboobi N, Tabatabaei SV, Blum HE, et al. Renal grafts from anti-hepatitis B core-positive donors: a quantitative review of the literature. Transpl Infect Dis. 2012;14:445–51.CrossRefGoogle Scholar
  80. 80.
    Chung RT, Feng S, Delmonico FL. Approach to the management of allograft recipients following the detection of hepatitis B virus in the prospective organ donor. Am J Transplant. 2001;1:185–91.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Dhillon GS, Levitt J, Mallidi H, et al. Impact of hepatitis B core antibody positive donors in lung and heart-lung transplantation: an analysis of the United Network for Organ Sharing Database. Transplantation. 2009;88:842–6.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Levitsky J, Doucette K, Practice ASTIDCo. Viral hepatitis in solid organ transplantation. Am J Transplant. 2013;13(Suppl 4):147–68.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Blanpain C, Knoop C, Delforge ML, et al. Reactivation of hepatitis B after transplantation in patients with pre-existing anti-hepatitis B surface antigen antibodies: report on three cases and review of the literature. Transplantation. 1998;66:883–6.CrossRefPubMedPubMedCentralGoogle Scholar
  84. 84.
    Lee J, Park JY, Huh KH, et al. Rituximab and hepatitis B reactivation in HBsAg-negative/anti-HBc-positive kidney transplant recipients. Nephrol Dial Transplant. 2017;32:906.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Reddy KR, Beavers KL, Hammond SP, et al. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:215–9; quiz e16-7CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    Wei HK, Loong CC, King KL, et al. HBsAg(+) donor as a kidney transplantation deceased donor. Transplant Proc. 2008;40:2097–9.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Jeng LB, Thorat A, Yang HR, et al. Successful use of hepatitis B surface antigen-positive liver grafts – an effective source for donor organs in endemic areas: a single-center experience. Ann Transplant. 2015;20:103–11.CrossRefPubMedPubMedCentralGoogle Scholar
  88. 88.
    Yu S, Yu J, Zhang W, et al. Safe use of liver grafts from hepatitis B surface antigen positive donors in liver transplantation. J Hepatol. 2014;61:809–15.CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Franchello A, Ghisetti V, Marzano A, et al. Transplantation of hepatitis B surface antigen-positive livers into hepatitis B virus-positive recipients and the role of hepatitis delta coinfection. Liver Transpl. 2005;11:922–8.CrossRefPubMedPubMedCentralGoogle Scholar
  90. 90.
    Chancharoenthana W, Townamchai N, Pongpirul K, et al. The outcomes of kidney transplantation in hepatitis B surface antigen (HBsAg)-negative recipients receiving graft from HBsAg-positive donors: a retrospective, propensity score-matched study. Am J Transplant. 2014;14:2814–20.CrossRefPubMedPubMedCentralGoogle Scholar
  91. 91.
    Raimondo G, Brunetto MR, Pontisso P, et al. Longitudinal evaluation reveals a complex spectrum of virological profiles in hepatitis B virus/hepatitis C virus-coinfected patients. Hepatology. 2006;43:100–7.CrossRefPubMedPubMedCentralGoogle Scholar
  92. 92.
    Romeo R, Del Ninno E, Rumi M, et al. A 28-year study of the course of Hepatitis Delta infection: a risk factor for cirrhosis and hepatocellular carcinoma. Gastroenterology. 2009;136:1629–38.CrossRefPubMedPubMedCentralGoogle Scholar
  93. 93.
    Fattovich G, Giustina G, Christensen E, et al. Influence of hepatitis delta virus infection on morbidity and mortality in compensated cirrhosis type B. The European Concerted Action on Viral Hepatitis (Eurohep). Gut. 2000;46:420–6.CrossRefPubMedPubMedCentralGoogle Scholar
  94. 94.
    Krogsgaard K, Kryger P, Aldershvile J, et al. Delta-infection and suppression of hepatitis B virus replication in chronic HBsAg carriers. Hepatology. 1987;7:42–5.CrossRefPubMedPubMedCentralGoogle Scholar
  95. 95.
    Samuel D, Zignego A, Reynes M, et al. Long-term clinical and virological outcome after liver transplantation for cirrhosis caused by chronic delta hepatitis. Hepatology. 1995;21:333–9.CrossRefPubMedPubMedCentralGoogle Scholar
  96. 96.
    David E, Rahier J, Pucci A, et al. Recurrence of hepatitis D (delta) in liver transplants: histopathological aspects. Gastroenterology. 1993;104:1122–8.CrossRefPubMedPubMedCentralGoogle Scholar
  97. 97.
    Heidrich B, Yurdaydin C, Kabacam G, et al. Late HDV RNA relapse after peginterferon alpha-based therapy of chronic hepatitis delta. Hepatology. 2014;60:87–97.CrossRefPubMedPubMedCentralGoogle Scholar

Authors and Affiliations

  1. 1.Department of Medicine, Division of Gastrointestinal and Liver DiseasesKeck School of Medicine of University of Southern CaliforniaLos AngelesUSA

Section editors and affiliations

  • Camille Nelson Kotton
    • 1
  1. 1.Infectious Diseases DivisionHarvard University Medical SchoolBostonUSA

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