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HBsAb와 HBcAb가 양성인 장기 공여자의 간조직에서 Hepatitis B Virus DNA의 발현

Detection of Hepatitis B Virus DNA in Liver Grafts Obtained from HBsAb and HBcAb Positive Organ Donors

장주영|이승규|김경모|정창우
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)|2007.09|Pediatric Gastroenterology, Hepatology & Nutrition|제10권 제2호|pp. 166-172

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참고문헌

주제분류소아과학

초록

목 적: 최근 HBsAb 및 HBcAb 양성인 공여자의 간이식편을 이식 받은 수혜자에서 신생 B형 간염이 발생하는 것이 보고 되고 있으며, 저자들도 약 40%에서 신생 B형 간염이 발생하는 것을 보고하였다. 한국인에서의 HBcAb 양성률은 50%가 넘는 것으로 보고하고 있는데, 이는 임상 간이식의 걸림돌이 될 수 있으며 저자들은 이를 예방하기 위한 일환으로써 본 연구를 시행하였다.방 법: 1997년 11월부터 1998년 11월까지 12개월 동안 서울 아산병원에서 생체 간이식 공여자가 과거 B형 간염과 C형 간염 감염의 증거가 없으면서 HBsAg 음성이면서 HBsAb 양성, HBcAb 양성인 성인 공여자 6명을 대상으로 하였다. 간이식 수술 시 동결 생검을 위하여 채취한 절편의 일부를 보관하여 실험에 사용하였다. 동결 절편 조직에서 DNA를 분리하여, HBV DNA의 표면 구역과 핵심 구역에 대한 시발체를 이용하여 이중 중합 효소 연쇄 반응을 시행하여 검사를 시행하였다.결 과: 공여자 6명의 조직에서 표면 구역이 모두 양성으로 관찰되었으며, 핵심 구역은 4명에서 양성으로 관찰되었다. 그 중 4명의 간을 이식받은 소아 수혜자는 모두 예방법을 시행하면서, 신생 B형 간염의 발생은 관찰되지 않고 있다.

Abstract

Purpose: It has recently been reported that de novo HBV infection following liver transplantation is caused by grafts from HBcAb positive donors, and this phenomenon has been observed in one third of the liver transplant patients in our center. Therefore, we investigated the presence of HBV virus DNA in liver tissues obtained from HBcAb positive donors to determine the mechanism by which de novo HBV infection occurs. Methods: This study was conducted on 6 patients that were HBsAg negative, HBsAb positive, and HBcAb positive who were donors for liver transplantation between November 1997 and November 1998 at Asan Medical Center. We isolated DNA from a portion of liver biopsy tissues that were obtained during the operation, and then identified the surface and core region of HBV DNA using nested PCR. In addition, four children who received liver grafts from these donors were monitored to determine if they became afflicted with non-HBV related diseases while receiving prophylaxis consisting of short-term HBIG treatment and long-term treatment with an antiviral agent. Results: The surface antigen region was identified in all 6 donors and the core antigen region was observed in 4 of the 6 donors. However, no episodes of de novo HBV infection with prophylaxis were observed. Conclusion: The results of this study support the results of previous studies, which indicated that HBV infection may be the main cause of de novo HBV infection in patients that receive HBsAb positive and HBcAb positive donor grafts.

참고문헌 (50)

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  46. Marusawa H, "Latent hepatitis B virus infection in healthy individuals with antibodies to hepatitis B core antigen", 31, pp.488~495 (2000)
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  48. "Summers J. Formation of the pool of covalently closed circular viral DNA in hepadnavirus-infected cells. Cell 1986", pp.451~60
  49. Hussain M, "Presence of intrahepatic (Total and ccc) HBV DNA is not predictive of HBV recurrence after liver transplantation", 13, pp.1137~1144 (2007)
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