Abstract
A 52 years-old caucasian man, with HIV chronic infection, underwent a liver transplantation in 2012 because of end stage liver disease due to HCV/HBV/HDV and HCC. Tacrolimus monotherapy was started as immune-suppression. After transplant, the patient became spontaneously HCV-RNA negative, HBV-HDV recurrence was prevented by tenofovir and anti-HBs immunoglobulins infusion and the patient remained HBsAg neg. In 2018 anti-HBs levels started to decline despite regular immunoglobulin infusion. Frequency and dosage of immunoglobulin infusions were increased but by the end of the year the patient became HBsAg positive with an HDV-RNA >19000 copies/ml; HBV-DNA remained undetectable.
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