  
New immunoassay effective in hepatitis B screening after liver transplantation
Last Updated: 2001-03-02 17:30:09 EST (Reuters Health)
WESTPORT, CT (Reuters Health) - A new serological immunoassay allows rapid detection of hepatitis B surface 'escape' mutants after liver transplantation, and may be more cost-effective than other tests.
As described in the March issue of the Journal of Medical Virology, the assay is based on a monoclonal antibody that recognizes both wild-type and mutant HBsAg. To study the efficacy of the assay, Dr. Nikolai V. Naoumov from the University College London and colleagues in the UK obtained blood samples before and after liver transplantation from 22 patients who received liver transplants for HbsAg positive cirrhosis.
After transplantation the subjects fell into three groups. Group A consisted of 12 patients who, despite receiving hepatitis B immunoglobulin, reinfected the graft. Group B was made up of six patients who received continuous hepatitis B immunoglobulin and had no recurrence of hepatitis B. In Group C there were four patients who had a recurrence of hepatitis B and had not received hepatitis B immunoglobulin, according to the report.
Among patients in Group A, when the new assay was used in conjunction with an immunoassay that is susceptible to HBsAg mutants, four of 12 cases of recurrent hepatitis B were found to be caused by surface antibody escape mutants, while eight cases were due to the wild-type hepatitis B, Dr. Naoumov's group reports.
For patients in Group B, the immunoassay of samples before transplantation showed that all these patients had hepatitis B with the wild-type HBsAg. Both sequence analysis and immunoassay did not detect HBsAg after transplantation.
As for patients in Group C "the pre- and post-transplant sera reacted on both the 'conserved' and the 'wild-type' assay showing that all these patients were infected with hepatitis B encoding a wild-type HBsAg," the researchers note. In all cases, these findings were confirmed by hepatitis B DNA sequencing.
"As well as providing a practical advantage over DNA sequence analysis, the serological assay will allow liver transplant recipients to be screened quickly for the presence of HbsAg mutant-bearing viruses and therefore [enable] the selection of appropriate prophylaxis before transplantation," Dr. Naoumov and colleagues conclude.
J Med Virol 2001;63:210-216.
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