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

doi:2009.15.2.131

Korean J Hepatol > Volume 15(2); 2009 > Article

The Korean Journal of Hepatology 2009;15(2): 131-139.
doi: https://doi.org/10.3350/kjhep.2009.15.2.131

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

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

Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea

ABSTRACT

Backgrounds
/Aims: This study examined the effects of hepatitis B virus (HBV) infection state and immunologic capability in both the recipients and donors of allogenic hematopoietic stem-cell transplantation (allo-HSCT) on changes in HBV serologic markers in recipients. Methods: A total of 537 patients underwent allo-HSCT for the treatment of leukemia, malignant lymphoma, and solid tumor. HBV serologic markers were examined in both recipients and donors prior to and following the transplantation. The mean follow-up period was 36.6 months (range 3-80 months). Results: Of the 537 patients who underwent allo-HSCT, 45 recipients were positive for HBsAg prior to transplantation. Of these 45 patients, 21 were transplanted from anti- HBs-positive donors and the remaining 24 were transplanted from anti-HBs-negative donors. In the former cases, seroconversion was noted in 4 of the 21 patients (19%). In the latter cases, however, no seroconversion was noted following the transplantation. Thirty patients who were negative for both HBsAg and anti-HBs were transplanted from anti-HBs-positive donors, and 15 out of 30 patients (50%) acquired anti-HBs. Four hundred and seven patients who were positive for anti-HBs were transplanted from anti-HBs-positive or HbsAg-negative donors; 8 of these proved HBsAg-positive following the transplantation. There were no changes in HBV serological markers following transplantation in 41 patients who were transplanted from HbsAg-positive donors. Conclusions: Due to the adoptive immunity that was transferred from anti-HBspositive donors, a seroconversion of HBsAg could occur in some HBsAg-positive recipients. HBsAg-positive donors had a lesser effect on the HBV serologic markers of recipients. However, a reactivation of HBV can occur following hematopoietic stem-cell transplantation in the cases of recipients or donors with a history of HBV, infection by an accompanying immune suppression. Therefore, prevention should be instigated. (Korean J Hepatol 2009;15:131-139)

KeyWords: Hepatitis B virus; Allogenic hematologic stem cell transplantation