Changes in serologic markers of hepatitis B in autologous hematopoietic stem cell transplantation recipients

Abstract

Introduction: Hepatitis B virus (HBV) infection is one of the most prominent health threats worldwide. Hepatitis B exacerbation is a significant cause of morbidity and mortality in patients who are the candidates of cytotoxic, immunosuppressive therapy and hematopoietic stem cell transplantation (HSCT) in areas where chronic hepatitis B infection is endemic. Patient and Methods: This retrospective study was conducted in Bone Marrow Transplantation Unit. A total of 64 patients, who underwent autologous HSCT were retrospectively reviewed. Results: A total of 64 patients with median age of 57 (22–79) years and gender distribution of 66% (n = 42) males and 34% (n = 22) females, who underwent autologous HSCT were included in the study. Three patients who were identified as hepatitis B surface antigen (HBsAg) positive prior to the transplantation had autologous HSCT under lamivudine prophylaxis. HBV reactivation had occurred in one of these patients. Hepatitis B infection (reverse seroconversion) was identified in one of the two patients who were HBsAg negative and hepatitis B core antibody (anti-HBc) positive prior to the treatment via serologic tests performed due to transaminase increases observed on day 407 in one case and on day 222 in the other. Conclusion: HBsAg positivity constitutes an independent risk factor for HSCT. In addition, it is necessary to administer prophylaxis and/or be more cautious in HBsAg negative patients prior to the transplantation and those with antibody positivity as they are more likely to develop reverse seroconversion.

Keywords

• Autologous hematopoietic stem cell transplantation
• hepatitis
• prophylaxis
• reactivation