High risk of hepatitis B-virus reactivation after hematopoietic cell transplantation in hepatitis B core antibody-positive patients

Kosei Matsue, Takatoshi Aoki, Jun Odawara, Hideaki Fujiwara, Kan Ichi Iwama, Shun Ichi Kimura, Masayuki Yamakura, Masami Takeuch

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

We investigated the serological changes in hepatitis B virus (HBV)-related markers in 55 and 26 hepatitis B surface antigen (HBsAg)-negative patients undergoing allogeneic and autologous stem cell transplantation, respectively, over the past 4 yr. Five of the 17 allogeneic and one of the five autologous patients with pretransplant anti-hepatitis B core antigen antibodies (anti-HBc) were HBsAg-positive after transplantation, whereas none of the patients negative for anti-HBc were HBsAg-positive in both groups. All patients who became HBsAg-positive received steroid-containing immunosuppressive therapy for chronic graft versus host disease (GVHD) or myeloma. Four of the six patients developed flare of HBV hepatitis, and two patients did not. One patient developed fulminant hepatitis treated with lamivudine and plasma exchange. Other five patients received entecavir from the detection of HBsAg. Although HBV-DNA levels became below the limit of detection in all patients, HBsAg positivity remained in three patients after 6 months of treatment. We concluded that anti-HBc positivity is a risk factor for reactivation of HBV after both autologous and allogeneic transplantation, and HBV-related markers should be monitored regularly in these patients. We also stress the efficacy of pre-emptive use of antiviral agents in controlling HBV replication and limiting hepatic injury due to reactivation of HBV in these patients.

Original languageEnglish
Pages (from-to)357-364
Number of pages8
JournalEuropean Journal of Haematology
Volume83
Issue number4
DOIs
Publication statusPublished - Oct 2009
Externally publishedYes

Fingerprint

Hepatitis B Antibodies
Cell Transplantation
Hepatitis B virus
Hepatitis B Surface Antigens
Hepatitis B Core Antigens
Hepatitis
Antibodies
Plasma Exchange
Lamivudine
Autologous Transplantation
Homologous Transplantation
Stem Cell Transplantation
Graft vs Host Disease
Immunosuppressive Agents
Virus Replication
Antiviral Agents
Limit of Detection

Keywords

  • Anti-HBc
  • Entecavir
  • HBV reactivation
  • HBV-DNA
  • Hematopoietic cell transplantation

ASJC Scopus subject areas

  • Hematology

Cite this

High risk of hepatitis B-virus reactivation after hematopoietic cell transplantation in hepatitis B core antibody-positive patients. / Matsue, Kosei; Aoki, Takatoshi; Odawara, Jun; Fujiwara, Hideaki; Iwama, Kan Ichi; Kimura, Shun Ichi; Yamakura, Masayuki; Takeuch, Masami.

In: European Journal of Haematology, Vol. 83, No. 4, 10.2009, p. 357-364.

Research output: Contribution to journalArticle

Matsue, Kosei ; Aoki, Takatoshi ; Odawara, Jun ; Fujiwara, Hideaki ; Iwama, Kan Ichi ; Kimura, Shun Ichi ; Yamakura, Masayuki ; Takeuch, Masami. / High risk of hepatitis B-virus reactivation after hematopoietic cell transplantation in hepatitis B core antibody-positive patients. In: European Journal of Haematology. 2009 ; Vol. 83, No. 4. pp. 357-364.
@article{3e20a0e624874d528d8f43af09bee1ca,
title = "High risk of hepatitis B-virus reactivation after hematopoietic cell transplantation in hepatitis B core antibody-positive patients",
abstract = "We investigated the serological changes in hepatitis B virus (HBV)-related markers in 55 and 26 hepatitis B surface antigen (HBsAg)-negative patients undergoing allogeneic and autologous stem cell transplantation, respectively, over the past 4 yr. Five of the 17 allogeneic and one of the five autologous patients with pretransplant anti-hepatitis B core antigen antibodies (anti-HBc) were HBsAg-positive after transplantation, whereas none of the patients negative for anti-HBc were HBsAg-positive in both groups. All patients who became HBsAg-positive received steroid-containing immunosuppressive therapy for chronic graft versus host disease (GVHD) or myeloma. Four of the six patients developed flare of HBV hepatitis, and two patients did not. One patient developed fulminant hepatitis treated with lamivudine and plasma exchange. Other five patients received entecavir from the detection of HBsAg. Although HBV-DNA levels became below the limit of detection in all patients, HBsAg positivity remained in three patients after 6 months of treatment. We concluded that anti-HBc positivity is a risk factor for reactivation of HBV after both autologous and allogeneic transplantation, and HBV-related markers should be monitored regularly in these patients. We also stress the efficacy of pre-emptive use of antiviral agents in controlling HBV replication and limiting hepatic injury due to reactivation of HBV in these patients.",
keywords = "Anti-HBc, Entecavir, HBV reactivation, HBV-DNA, Hematopoietic cell transplantation",
author = "Kosei Matsue and Takatoshi Aoki and Jun Odawara and Hideaki Fujiwara and Iwama, {Kan Ichi} and Kimura, {Shun Ichi} and Masayuki Yamakura and Masami Takeuch",
year = "2009",
month = "10",
doi = "10.1111/j.1600-0609.2009.01291.x",
language = "English",
volume = "83",
pages = "357--364",
journal = "European Journal of Haematology",
issn = "0902-4441",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - High risk of hepatitis B-virus reactivation after hematopoietic cell transplantation in hepatitis B core antibody-positive patients

AU - Matsue, Kosei

AU - Aoki, Takatoshi

AU - Odawara, Jun

AU - Fujiwara, Hideaki

AU - Iwama, Kan Ichi

AU - Kimura, Shun Ichi

AU - Yamakura, Masayuki

AU - Takeuch, Masami

PY - 2009/10

Y1 - 2009/10

N2 - We investigated the serological changes in hepatitis B virus (HBV)-related markers in 55 and 26 hepatitis B surface antigen (HBsAg)-negative patients undergoing allogeneic and autologous stem cell transplantation, respectively, over the past 4 yr. Five of the 17 allogeneic and one of the five autologous patients with pretransplant anti-hepatitis B core antigen antibodies (anti-HBc) were HBsAg-positive after transplantation, whereas none of the patients negative for anti-HBc were HBsAg-positive in both groups. All patients who became HBsAg-positive received steroid-containing immunosuppressive therapy for chronic graft versus host disease (GVHD) or myeloma. Four of the six patients developed flare of HBV hepatitis, and two patients did not. One patient developed fulminant hepatitis treated with lamivudine and plasma exchange. Other five patients received entecavir from the detection of HBsAg. Although HBV-DNA levels became below the limit of detection in all patients, HBsAg positivity remained in three patients after 6 months of treatment. We concluded that anti-HBc positivity is a risk factor for reactivation of HBV after both autologous and allogeneic transplantation, and HBV-related markers should be monitored regularly in these patients. We also stress the efficacy of pre-emptive use of antiviral agents in controlling HBV replication and limiting hepatic injury due to reactivation of HBV in these patients.

AB - We investigated the serological changes in hepatitis B virus (HBV)-related markers in 55 and 26 hepatitis B surface antigen (HBsAg)-negative patients undergoing allogeneic and autologous stem cell transplantation, respectively, over the past 4 yr. Five of the 17 allogeneic and one of the five autologous patients with pretransplant anti-hepatitis B core antigen antibodies (anti-HBc) were HBsAg-positive after transplantation, whereas none of the patients negative for anti-HBc were HBsAg-positive in both groups. All patients who became HBsAg-positive received steroid-containing immunosuppressive therapy for chronic graft versus host disease (GVHD) or myeloma. Four of the six patients developed flare of HBV hepatitis, and two patients did not. One patient developed fulminant hepatitis treated with lamivudine and plasma exchange. Other five patients received entecavir from the detection of HBsAg. Although HBV-DNA levels became below the limit of detection in all patients, HBsAg positivity remained in three patients after 6 months of treatment. We concluded that anti-HBc positivity is a risk factor for reactivation of HBV after both autologous and allogeneic transplantation, and HBV-related markers should be monitored regularly in these patients. We also stress the efficacy of pre-emptive use of antiviral agents in controlling HBV replication and limiting hepatic injury due to reactivation of HBV in these patients.

KW - Anti-HBc

KW - Entecavir

KW - HBV reactivation

KW - HBV-DNA

KW - Hematopoietic cell transplantation

UR - http://www.scopus.com/inward/record.url?scp=70349131938&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70349131938&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0609.2009.01291.x

DO - 10.1111/j.1600-0609.2009.01291.x

M3 - Article

C2 - 19508685

AN - SCOPUS:70349131938

VL - 83

SP - 357

EP - 364

JO - European Journal of Haematology

JF - European Journal of Haematology

SN - 0902-4441

IS - 4

ER -