Change in the serologic markers of hepatitis B after allogenic hematopoietic stem-cell transplantation

Woo, Seong Yong; Cho, Se Hyun; Lee, Se Min; Koh, Myoung Beom; Noh, Chee Ho; Kim, Chang Wook; Choi, Jong Young; Yang, Jin Mo; Han, Ji-Hye; Lee, Young Sok

doi:10.3350/kjhep.2009.15.2.131

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…RS is also a testament to the long‐lived latent nature of covalently closed circular DNA (cccDNA) in hepatocytes, which enables HBV reactivation after loss of immunological control . Published studies have shown that RS does not occur in patients who have received donor stem cells with positive antiHBsAb, which have been shown to have protective effects , and indeed the potential exists for HBsAg seroconversion in the recipient owing to adoptive immunity from the donor .…”

Section: Discussionmentioning

confidence: 99%

“…As such, we were unable to fully account for the finding of persistent antiHBcAb positivity after allo‐HSCT with a determination of clinical risk factors contributing to HBV exposure. In addition, the lack of routine regular testing of both patient and donor antiHBsAb levels made it difficult to determine the relationship and potential protective effect of antiHBsAbs, as reported in published studies .…”

Section: Discussionmentioning

confidence: 99%

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Hepatitis B serological changes following allogeneic bone marrow transplantation

Teh

Slavin

Szer

et al. 2012

Transplant Infectious Dis

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Hepatitis B (HBV) reverse seroconversion (RS) in immunocompromised patients with serological evidence of past HBV infection (hepatitis B surface antigen [sAg] negative, core antibody [cAb] positive) has been reported with increasing frequency following allogeneic hematopoietic stem cell transplant (allo-HSCT). We performed a retrospective review of serial HBV serological testing in patients who had undergone allo-HSCT at our center between 2000 and 2006. We identified 12 patients with serological evidence of past HBV, including 1 case of RS. Although 7 of these 12 patients had no changes in serological markers detected after transplantation, 5 of them had declining levels of hepatitis B surface antibodies [sAb], with 2 to < 10 IU/mL. The remaining 4 patients with past HBV had loss of antiHBcAb. An additional 14 patients developed isolated antiHBcAb post allo-HSCT in the setting of receiving HBV screened (HBsAg, antiHBcAb) negative donor stem cells. Monitoring of HBV serological markers (including antiHBsAb) and HBV DNA levels pre allo-HSCT in recipients and donors, and post allo-SCT in recipients, would allow early detection and treatment of RS and identify new acquisition of HBV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatitis B serological changes following allogeneic bone marrow transplantation

Teh

Slavin

Szer

et al. 2012

Transplant Infectious Dis

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Reactivation of hepatitis B (reverse seroconversion) after melphalan/dexamethasone therapy for primary amyloidosis: a case report

Moon

Kim

et al. 2015

J Med Case Reports

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IntroductionHepatitis B virus (HBV) reactivation (so-called reverse seroconversion) is a rare but known complication of hematopoietic stem cell transplantation, immunosuppressive therapy, or high-dose chemotherapy plus rituximab. This event is linked to a treatment-related fall in titers of antibodies to hepatitis B surface antigen (HBsAb) below the protective threshold level.Case presentationA 77-year-old Korean man diagnosed with primary amyloidosis was started on melphalan/dexamethasone combination therapy. During treatment, laboratory indices of hepatic function suddenly deteriorated, and he developed acute hepatitis through reverse HBV seroconversion, becoming positive for hepatitis B surface antigen (HBsAg) and negative for HBsAb. HBV DNA was also detectable in serum to a profound extent. Normal liver function was gradually restored during the course of antiviral therapy (entecavir).ConclusionsHBV reactivation may lead to fatal liver disease in a significant percentage of patients. As a result, physicians often screen for HBsAg and HBsAb prior to initiating chemotherapy, advising antiviral treatment in patients seropositive for HBsAg, even in the absence of hepatitis B e antigen. Here, a case of HBV reactivation is described, involving a patient given relatively low-dose chemotherapy (melphalan/dexamethasone) for primary amyloidosis.

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Change in the serologic markers of hepatitis B after allogenic hematopoietic stem-cell transplantation

Cited by 2 publications

References 15 publications

Hepatitis B serological changes following allogeneic bone marrow transplantation

Hepatitis B serological changes following allogeneic bone marrow transplantation

Reactivation of hepatitis B (reverse seroconversion) after melphalan/dexamethasone therapy for primary amyloidosis: a case report

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