vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2022-3-37-41vtio-1512Research ArticleКлиническая трансплантологияClinical TransplantologyHBV-инфекция de novo у пациентов после трансплантации печениDe novo hepatitis B virus infection after liver transplantationНикогосоваА. Д.NikogosovaA. D.

Никогосова Анна Дмитриевна

Адрес: 123182, Москва, ул. Щукинская, д. 1Тел. (958) 828-32-09

Anna Nikogosova

Address: 1, Shchukinskaya str., Moscow, 123182Phone: (958) 828-32-09

benevolenskaya.a@gmail.comУмрикД. В.UmrikD. V.

Москва

Moscow

ЦирульниковаО. М.TsirulnikovaO. M.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава РоссииРоссияShumakov National Medical Research Center of Transplantology and Artificial OrgansRussian FederationФГБУ «Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова» Минздрава России; ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский университет)РоссияShumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov UniversityRussian Federation2022230820222433741Copyright © Никогосова А.Д., Умрик Д.В., Цирульникова О.М., 20222022Никогосова А.Д., Умрик Д.В., Цирульникова О.М.Nikogosova A.D., Umrik D.V., Tsirulnikova O.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1512

Вирусный гепатит В (HBV-инфекция) de novo после трансплантации печени представляет собой развитие инфекции у пациента, страдавшего заболеванием печени, этиологически не связанным с HBV-инфекцией, и не имевшего маркеров HBV-инфекции до операции. Цель исследования: проанализировать клинические особенности и характеристики HBV-инфекции de novo и оценить эффективность терапии аналогами нуклеоз(т)идов у пациентов после трансплантации печени. Материалы и методы. В исследовании было рассмотрено 247 взрослых пациентов, перенесших трансплантацию печени от посмертного донора в период с 2016-го по 2022 г. в ФГБУ «НМИЦ ТИО им. ак. В.И. Шумакова» и не имевших до трансплантации маркеров HBV-инфекции. Результаты. У 22 (7%) из 247 пациентов были выявлены маркеры HBV-инфекции de novo в срок от 5 до 69 месяцев. На момент выявления ДНК HBV среднее значение АЛТ у пациентов составило 53,3 ± 36,4 Ед/л, АСТ – 54,5 ± 33,0 Ед/л. Всем пациентам были назначены аналоги нуклеотидов. В результате проводимой терапии отмечено статистически значимое снижение среднего значения АЛТ до 31,5 ± 24,2 Ед/л (р = 0,049), АСТ до 33,33 ± 21,5 Ед/л (р = 0,025). После лечения (6 ± 3 мес.) в большинстве случаев (18 человек, 81%) наличие ДНК HBV в плазме крови не определялось. Заключение. При своевременном выявлении факторов риска развития HBV-инфекции de novo, диагностике ее на ранней стадии и немедленном начале лечения можно предотвратить серьезное повреждение трансплантата.

De novo hepatitis B virus (HBV) infection developing after liver transplantation (LTx) is the development of infection in a patient with liver disease etiologically unrelated to HBV infection and who had no preoperative HBV markers. Objective: to analyze the clinical features and characteristics of de novo HBV infection and evaluate the efficacy of nucleos(t)ide analogue therapy in liver transplant recipients. Materials and methods. The study involved 247 adult patients who underwent deceased donor LTx from 2016 to 2022 at Shumakov National Medical Research Center of Transplantology and Artificial Organs and who had no pre-transplant HBV markers. Results. Twenty-two (7%) of 247 patients had de novo HBV markers from 5 to 69 months. At the time HBV DNA was detected, the mean alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in the patients was 53.3 ± 36.4 IU/L and 54.5 ± 33.0 IU/L, respectively. All patients received nucleos(t)ide analogues (NAs). The therapy led to a statistically significant decrease in the mean ALT level to 31.5 ± 24.2 IU/L (p = 0.049)

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The authors declare that there are no conflicts of interest present.