Hepatitis B serological changes following allogeneic bone marrow transplantation

Abstract

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.

Infected hematopoietic stem cells and with integrated HBV DNA generate defective T cells in chronic HBV infection patients

“…Few reports demonstrated the development of immunity against HBV after stem cell transplantation . Furthermore, some studies have reported seroconversion in chronic hepatitis B infection after stem cell transplantation . These studies implied that stem cell transplantation led to immunologic reconstitution in patients with chronic HBV infection.…”

Adoptive donor immunity protects against resolved hepatitis B virus reactivation after allogeneic haematopoietic stem cell transplantation in the world's largest retrospective cohort study

“…This is the largest cohort study conducted on this topic (Table V) with the highest number of rHBV (445 cases) and HBV-RS patients (21 cases), thereby providing more reliable analysis of individual risk factors. Previous studies were either case reports (Hashino et al, 2002;Kempinska et al, 2005;Schubert et al, 2013), small case series (Knoll et al, 2007;Hammond et al, 2009;Matsue et al, 2009;Park et al, 2011;Vigano et al, 2011;Teh et al, 2013;Mikulska et al, 2014) or after autologous HSCT (Uhm et al, 2007;Matsue et al, 2009;Borentain et al, 2010). The 5-year incidence of 10Á5% for HBV-RS warranted that this issue should not be overlooked.…”

“…return to HBsAg positivity, may occur. Potentially lethal hepatitis can happen if diagnosis is delayed, and has been sporadically reported in the United States (Hammond et al , ; Ramos et al , ), Europe (Knoll et al , ; Vigano et al , ; Mikulska et al , ) and the Asia‐Pacific region (Park et al , ; Teh et al , ). In addition to efforts focused on reducing post‐HSCT mortality by reactivation of chronic HBV carriers (Hui et al , ,; Tomblyn et al , ; Nakamoto et al , ), the threat from HBV‐RS for rHBV has recently been noted.…”

A comparison of lamivudine vs entecavir for prophylaxis of hepatitis B virus reactivation in allogeneic hematopoietic stem cell transplantation recipients: a single-institutional experience

“…Currently, however, comparative studies on the efficacy and safety of these two drugs in controlling HBV reactivation in allo-HSCT recipients are rarely reported. 10,15,16 To our knowledge, this is the first comparison study with a large sample size and long-term follow-up involving allo-HSCT Cumulative incidence curves of any severity of HBV reactivation-related hepatitis (a) and severe hepatitis (b) in the lamivudine and entecavir groups following HSCT. Differences between cumulative incidence curves were tested using the log rank test.…”

“…Some retrospective and prospective studies have indicated that lamivudine and entecavir are both effective for controlling HBV reactivation in allo-HSCT recipients. 9,10 However, comparative studies on the efficacy and safety of these two drugs are rarely reported. In addition, the sample sizes are small and follow-up times are short in these studies, thus introducing the potential for skewed results.…”