Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation
Objective: The reactivation rate of dormant hepatitis B virus (HBV) in the liver is between 4.1% and 41.5% in immune-compromised patients. The disappearance of hepatitis B surface antibody (anti-HBs) can be an alarm for hepatitis B reactivation. In this study, the changes in serological status, reac...
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doaj-73c8bf93d41347ceba3f566d5272bc5b2021-01-24T18:17:12ZengKARE PublishingErciyes Medical Journal2149-22472020-12-01431313610.14744/etd.2020.36786EMJ-36786Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell TransplantationZeynep Türe0Gamze Kalin Unuvar1Hüseyin Nadir Kahveci2Muzaffer Keklik3Ayşegul Ulu Kilic4Department of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Hematology, Erciyes University Faculty of Medicine, Kayseri, TurkeyDepartment of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, TurkeyObjective: The reactivation rate of dormant hepatitis B virus (HBV) in the liver is between 4.1% and 41.5% in immune-compromised patients. The disappearance of hepatitis B surface antibody (anti-HBs) can be an alarm for hepatitis B reactivation. In this study, the changes in serological status, reactivation rates, and antiviral prophylaxis rates were evaluated. Materials and Methods: A retrospective study was conducted involving patients who were followed up at Erciyes University HSCT Center between January 2018 and July 2019. The demographic data, type of hematological disease, pre- and post-transplant status of HBV, presence of antiviral prophylaxis, and frequency of hepatitis B flare were evaluated. Results: One hundred and seven patients were included in this study. The median follow-up duration was 18 months. New chemotherapy protocols were initiated in 36 patients due to progression and in 23 patients with a diagnosis of graft-versus-host disease. Anti-HBs levels decreased in 60% of the patients, and anti-HBs levels decreased to below the protective level in 13% of the patients. Among the 107 patients, 38 had resolved hepatitis B infection before transplantation, and 20 and four of 18 patients (22%) who did not receive antiviral prophylaxis developed HBV seroconversion and hepatitis B flare. The median levels of anti-HBs titers after transplantation were 167 IU/L and 15 IU/L in groups that received and did not receive antiviral prophylaxis, respectively (p=0.028). Conclusion: Antiviral prophylaxis should be administered in patients positive for hepatitis B core antibody before hematopoietic stem-cell transplantation. Measuring HBV serological parameters at regular intervals is essential in the high-risk group.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-36786hepatitis bhematopoietic setem cell transplantationreverse seroconversionhbv reactivation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zeynep Türe Gamze Kalin Unuvar Hüseyin Nadir Kahveci Muzaffer Keklik Ayşegul Ulu Kilic |
spellingShingle |
Zeynep Türe Gamze Kalin Unuvar Hüseyin Nadir Kahveci Muzaffer Keklik Ayşegul Ulu Kilic Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation Erciyes Medical Journal hepatitis b hematopoietic setem cell transplantation reverse seroconversion hbv reactivation |
author_facet |
Zeynep Türe Gamze Kalin Unuvar Hüseyin Nadir Kahveci Muzaffer Keklik Ayşegul Ulu Kilic |
author_sort |
Zeynep Türe |
title |
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation |
title_short |
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation |
title_full |
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation |
title_fullStr |
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation |
title_full_unstemmed |
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation |
title_sort |
overlooked prophylaxis of hepatitis b in patients undergoing hematopoietic stem cell transplantation |
publisher |
KARE Publishing |
series |
Erciyes Medical Journal |
issn |
2149-2247 |
publishDate |
2020-12-01 |
description |
Objective: The reactivation rate of dormant hepatitis B virus (HBV) in the liver is between 4.1% and 41.5% in immune-compromised patients. The disappearance of hepatitis B surface antibody (anti-HBs) can be an alarm for hepatitis B reactivation. In this study, the changes in serological status, reactivation rates, and antiviral prophylaxis rates were evaluated.
Materials and Methods: A retrospective study was conducted involving patients who were followed up at Erciyes University HSCT Center between January 2018 and July 2019. The demographic data, type of hematological disease, pre- and post-transplant status of HBV, presence of antiviral prophylaxis, and frequency of hepatitis B flare were evaluated.
Results: One hundred and seven patients were included in this study. The median follow-up duration was 18 months. New chemotherapy protocols were initiated in 36 patients due to progression and in 23 patients with a diagnosis of graft-versus-host disease. Anti-HBs levels decreased in 60% of the patients, and anti-HBs levels decreased to below the protective level in 13% of the patients. Among the 107 patients, 38 had resolved hepatitis B infection before transplantation, and 20 and four of 18 patients (22%) who did not receive antiviral prophylaxis developed HBV seroconversion and hepatitis B flare. The median levels of anti-HBs titers after transplantation were 167 IU/L and 15 IU/L in groups that received and did not receive antiviral prophylaxis, respectively (p=0.028).
Conclusion: Antiviral prophylaxis should be administered in patients positive for hepatitis B core antibody before hematopoietic stem-cell transplantation. Measuring HBV serological parameters at regular intervals is essential in the high-risk group. |
topic |
hepatitis b hematopoietic setem cell transplantation reverse seroconversion hbv reactivation |
url |
https://jag.journalagent.com/z4/download_fulltext.asp?pdir=erciyesmedj&un=EMJ-36786 |
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