Effectiveness of Prophylactic Anti-HBV Therapy in Allogeneic Hematopoietic Stem Cell Transplantation with HBsAg Positive Donors

Hui, Chee–Kin; Lie, Albert K. W.; Au, Wing‐Yan; Ma, S.K.; Leung, Y.-Y. R.; Zhang, Haiying; Sun, Jian; Cheung, Wai‐Lung; Chim, Chor Sang; Kwong, Yok–Lam; Liang, Raymond; Lau, George

doi:10.1111/j.1600-6143.2005.00887.x

Cited by 56 publications

(32 citation statements)

References 29 publications

(38 reference statements)

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“…49,125,126 Recently, pre-emptive antiviral therapy before HSCT in all positive donors and all recipients as well as HBV vaccination in all HBsAg-negative recipients has been shown to significantly reduce HBV-related hepatitis and hepatic failure. 127 Limitations of Lamivudine. Careful clinical monitoring is still required despite the potential benefits of the prophylactic lamivudine approach.…”

Section: Prevention Of Hbv Reactivationmentioning

confidence: 99%

Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy

2006

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It is estimated conservatively that more than one third of the world's population has been infected with the hepatitis B virus (HBV) and that there are 350 million people with chronic infection, 75% of whom live in Southeast Asia and the Western Pacific regions. [1][2][3] Reactivation of HBV infection is now a well-recognized complication in infected patients who undergo cytotoxic chemotherapy for cancer. The condition ranges from asymptomatic self-limiting anicteric hepatitis to severe, potentially fatal progressive decompensated hepatitis. With the increasing use of potent cytotoxic chemotherapy, reactivation of hepatitis B in endemic regions is becoming a common clinical problem. This adversely affects advances made in various forms of cancer therapy. In this review, we consider the diagnosis, prevention, and management of HBV reactivation in association with chemotherapy and hematopoietic stem cell transplantation, particularly in light of the availability of effective prophylactic antiviral therapy.Reactivation of HBV was first described by Wands et al., 4 who in 1975 reported the condition in 20 patients with lympho-and myeloproliferative disorders. Most of the cases reported since were similar in patients with hematological malignancies-in particular, lymphomas. [4][5][6][7][8][9][10][11][12][13][14][15][16] The skewed observations may be due to the fact that these patients are often subjected to intense myelosuppressive treatment regimens, the malignancies per se are often associated with an immunocompromised state, and the patients have been consistently reported to have a higher rate of hepatitis B surface antigen (HBsAg) seropositivity than the normal population. 9,[17][18][19] Over the past decade, HBV reactivation has been increasingly observed in patients with solid tumors. [18][19][20][21][22] In patients with hepatocellular carcinoma (85% of whom have chronic HBV infection in Southern China 3,23 ), hepatitis following systemic chemotherapy has been reported in 60% 20,24 ; this is mostly attributed to HBV reactivation, which has a 30% mortality rate. 20 In other cancer subpopulations, the incidence of HBV reactivation ranges between 25% and 40%. 10,15,18,21,25 In the setting of hematopoietic stem cell transplantation (HSCT) for various hematological and oncological conditions, HBV reactivation has been reported in over 50% of patients. [26][27][28] This is related to the intense chemotherapy with or without total body irradiation, and the coexistence of acute graft-versus-host disease. 28 Although the frequency of viral reactivation among HBsAg-positive patients with cancer would be expected to be the same irrespective of geographical area, the prevalence of HBV infection varies between different populations from 10% to 25% in endemic areas to less than 1% in others. 3,10,29 As a result, there would be proportional difference in the incidence of viral reactivation in a given population. Definitions and DiagnosisIn early reports, the diagnosis of HBV reactivation was based on HBsAg and hepatitis B ...

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Section: Prevention Of Hbv Reactivationmentioning

confidence: 99%

Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy

2006

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“…Most transplantation centers have regarded HBV infection as a relative contraindication for organ transplantation [5,6] . BMT with HBsAg-positive donors has been reported to be associated with an increased incidence of HBVrelated hepatitis, severe liver-related complications, fatal liver failure and death [1,2,[6][7][8][9][10][11] . However, a few reports show that HBsAg might be present transiently in some patients after receiving bone marrow graft from HBsAg-positive donors [1,2] .…”

Section: Discussionmentioning

confidence: 99%

“…Combination therapy of HBIg and lamivudine offers synergistic protection against HBV infection and appears to be more effective than a single agent for prophylaxis after HBV-related liver transplantation [13] . A recent study proposed a three-level approach when hematopoietic stem cell transplantation (HSCT) was performed with a HBV-positive donor [6] . The three-level approach consisted of a pre-HSCT reduction of HBV viral replication in donors by lamivudine, a pre-HSCT enhancement of the recipient's anti-HBV immunity by HBV vaccination, and finally, a post-HSCT suppression of HBV viral replication in recipients with lamivudine [6] .…”

Section: Discussionmentioning

confidence: 99%

“…A recent study proposed a three-level approach when hematopoietic stem cell transplantation (HSCT) was performed with a HBV-positive donor [6] . The three-level approach consisted of a pre-HSCT reduction of HBV viral replication in donors by lamivudine, a pre-HSCT enhancement of the recipient's anti-HBV immunity by HBV vaccination, and finally, a post-HSCT suppression of HBV viral replication in recipients with lamivudine [6] . In that paper, patients received lamivudine for 52 wk after HSCT; however, our patient received lamivudine for 72 wk, and treatment with…”

Section: Discussionmentioning

confidence: 99%

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A prophylactic approach for bone marrow transplantation from a hepatitis B surface antigen-positive donor

Sobhonslidsuk

Ungkanont²

2007

WJG

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“…Commercial assays have included a solid-phase hybridization capture assay (Hybrid Capture II; Digene, Gaithersburg, MD) and a first-generation branched DNA signal amplification assay (Versant; Bayer Diagnostics, Emeryville, CA). However, these assays were limited by a lack of standardization and variability in their sensitivities, with a lower limit of detection of 10 5 to 10 6 copies/ml (5,8,11,16). In addition to the lack of sensitivity, none of these commercial assays have detection ranges that can reliably detect the wide dynamic range of HBV DNA levels of more than 10 10 copies/ml found in certain populations of HBV-infected patients.…”

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confidence: 99%

Comparison of Real-Time PCR Assays for Monitoring Serum Hepatitis B Virus DNA Levels during Antiviral Therapy

et al. 2006

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Effectiveness of Prophylactic Anti-HBV Therapy in Allogeneic Hematopoietic Stem Cell Transplantation with HBsAg Positive Donors

Cited by 56 publications

References 29 publications

Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy

Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy

A prophylactic approach for bone marrow transplantation from a hepatitis B surface antigen-positive donor

Comparison of Real-Time PCR Assays for Monitoring Serum Hepatitis B Virus DNA Levels during Antiviral Therapy

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