{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:51:50Z","timestamp":1775641910053,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP21fk0310102"],"award-info":[{"award-number":["JP21fk0310102"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP24fk0310518"],"award-info":[{"award-number":["JP24fk0310518"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP25fk0310543"],"award-info":[{"award-number":["JP25fk0310543"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18K15742"],"award-info":[{"award-number":["18K15742"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K09138"],"award-info":[{"award-number":["19K09138"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K11147"],"award-info":[{"award-number":["24K11147"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In hepatitis B surface antigen (HBsAg)\u2010negative recipients with antibody to hepatitis B core antigen (anti\u2010HBc)\u2010positive liver grafts, hepatitis B virus (HBV) can be reactivated under post\u2010transplant immunosuppression. We recently reported a median intrahepatic covalently closed circular DNA (cccDNA) level of 238 copies\/\u03bcg in HBsAg\u2010positive patients. Meanwhile, the potential levels of intrahepatic cccDNA in anti\u2010HBc\u2010positive grafts have never been focused on as a factor for HBV recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 168 patients who underwent living donor liver transplantation (LDLT) between 2018 and 2022, 4 HBsAg\u2010negative recipients with anti\u2010HBc\u2010positive grafts were consecutively enrolled in this prospective study. Intrahepatic cccDNA levels in donor grafts were measured based on an intraoperative liver biopsy and digital droplet polymerase chain reaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all four donor grafts, intrahepatic cccDNA levels ranged from 5.2 to 408 copies\/\u03bcg, and all were negative for the high\u2010sensitivity hepatitis B core\u2010related antigen. Three of four recipients experienced HBV reactivation 14\u201324\u2009months after LDLT. Two patients developed hepatitis with high HBV DNA and HBsAg levels, escape mutations (G145R \u00b1 K141R) with genotype B or C were detected. Entecavir therapy achieved serological and virological clearance within 2\u20139\u2009months. The fourth patient remained recurrence\u2010free during 36\u2009months of follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Even among patients with resolved HBV infection, there are cases possessing intrahepatic cccDNA levels as high as or even higher than those in HBsAg\u2010positive patients. To resolve this critical pitfall in immunosuppressed patients, the development of serum markers that precisely reflect intrahepatic cccDNA levels will be essential for improving HBV prophylaxis strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.70324","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:20:58Z","timestamp":1773292858000},"page":"1335-1341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Intrahepatic cccDNA in Resolved HBV Infection: Insights From Living Donor Liver Transplantation With Anti\u2010HBc\u2010Positive Grafts"],"prefix":"10.1111","volume":"41","author":[{"given":"Sung\u00a0Kwan","family":"Bae","sequence":"first","affiliation":[{"name":"Artificial Organ and Transplantation Division, Department of Surgery University of Tokyo  Tokyo 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