TY - JOUR
T1 - Hepatitis B virus reactivation with clinical flare in allogeneic stem cell transplants with chronic graft-versus-host disease
AU - Seth, P.
AU - Alrajhi, A. A.
AU - Kagevi, I.
AU - Chaudhary, M. A.
AU - Colcol, E.
AU - Sahovic, E.
AU - Aljurf, M.
AU - Gyger, M.
PY - 2002
Y1 - 2002
N2 - We conducted a retrospective study with the aim of identifying risk factors and clinical characteristics associated with HBV reactivation and clinical flare after allogeneic stem cell transplantation (aSCT). We reviewed the King Faisal Specialist Hospital and Research Center International Bone Marrow Transplant Registry database from January 1998 to June 2000. Complete serological screening for HBV was available in 128 of 131 patients transplanted during that period. Fifty-four (42%) had evidence of prior infection and recovery from HBV before transplant (hepatitis B core antibody positive, B surface antigen negative), Forty-two were evaluable for HBV reactivation and clinical flare. Six (14%) reactivated with clinical flare as documented by seroconversion and/or positive HBV DNA in the serum with biochemical hepatitis at 5.5, 18, 18, 19, 21 and 23 months post-transplant. Five of fifteen patients with chronic graft-versus-host disease (cGVHD) reactivated with clinical flare in contrast to 1/27 without cGVHD (RR: 9.0, 95% CI: 1.2-70.1 P < 0.02). HBV reactivation with clinical flare occurred during immunosuppressive therapy tapering or withdrawal in all patients. In conclusion, hepatitis B core antibody positive allogeneic stem cell recipients with cGVHD are at significant risk of HBV reactivation with clinical flare.
AB - We conducted a retrospective study with the aim of identifying risk factors and clinical characteristics associated with HBV reactivation and clinical flare after allogeneic stem cell transplantation (aSCT). We reviewed the King Faisal Specialist Hospital and Research Center International Bone Marrow Transplant Registry database from January 1998 to June 2000. Complete serological screening for HBV was available in 128 of 131 patients transplanted during that period. Fifty-four (42%) had evidence of prior infection and recovery from HBV before transplant (hepatitis B core antibody positive, B surface antigen negative), Forty-two were evaluable for HBV reactivation and clinical flare. Six (14%) reactivated with clinical flare as documented by seroconversion and/or positive HBV DNA in the serum with biochemical hepatitis at 5.5, 18, 18, 19, 21 and 23 months post-transplant. Five of fifteen patients with chronic graft-versus-host disease (cGVHD) reactivated with clinical flare in contrast to 1/27 without cGVHD (RR: 9.0, 95% CI: 1.2-70.1 P < 0.02). HBV reactivation with clinical flare occurred during immunosuppressive therapy tapering or withdrawal in all patients. In conclusion, hepatitis B core antibody positive allogeneic stem cell recipients with cGVHD are at significant risk of HBV reactivation with clinical flare.
KW - Cytotoxic T lymphocytes
KW - Graft-versus-host disease
KW - Hepatitis B core antibody
KW - Hepatitis B virus
KW - Immunosuppression
KW - Reactivation
UR - http://www.scopus.com/inward/record.url?scp=0036669971&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036669971&partnerID=8YFLogxK
U2 - 10.1038/sj.bmt.1703614
DO - 10.1038/sj.bmt.1703614
M3 - Article
C2 - 12189538
AN - SCOPUS:0036669971
SN - 0268-3369
VL - 30
SP - 189
EP - 194
JO - Bone marrow transplantation
JF - Bone marrow transplantation
IS - 3
ER -