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  • Original Article
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Post-transplant Events

Risk of hepatitis B surface antigen seroreversion after allogeneic hematopoietic SCT

Bone Marrow Transplantation volume 46, pages 125–131 (2011)Cite this article

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Abstract

Allogeneic hematopoietic SCT (HSCT) increases the risk of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) carriers but the incidence, risk factors and course of HBV reactivation after HSCT in HBsAg-negative/anti-hepatitis B core antigen (anti-HBc)-positive recipients are not well known. A total of 50 HBsAg-negative/anti-HBc-positive HSCT recipients with onco-hematological diseases, underwent sequential clinical and laboratory examinations, including serum HBsAg, during follow-up. Serum HBV DNA collected at HSCT was retrospectively amplified by a sensitive PCR assay. During 17 months of follow-up, six (12%) patients had seroreverted to HBsAg, 7–32 months after HSCT, with 1- and 5-year cumulative rates of 13 and 22%. HBsAg seroreversion was associated with serum HBeAg higher than 8 log10 copies per ml HBV DNA and a 1.5 to 36 fold increase of serum alanine aminotransferase leading to HBeAg-positive chronic hepatitis B in all patients. Patients with chronic onco-hematological disease and long-lasting immunosuppression following HSCT had a higher risk of HBsAg seroreversion independently of serum HBV DNA levels at HSCT. HBsAg-negative/anti-HBc-positive HSCT recipients with chronic onco-hematological disease carry a significant risk of HBsAg seroreversion and HBeAg-positive chronic hepatitis B, independently of serum levels of HBV DNA at transplantation.

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Acknowledgements

We thank Miss Caterina M Puricelli for her expert secretarial assistance.

Author information

Author notes

  1. M Viganò and C Vener: These authors contributed equally to this work.

Authors and Affiliations

  1. First Division of Gastroenterology, Department of Medicine, A M and A Migliavacca Center for Liver Disease, Fondazione IRCCS Ca′ Grande Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy

    M Viganò, P Lampertico, F Facchetti & M Colombo

  2. Hematology I—Bone Marrow Transplantation Unit, Fondazione IRCCS Ca′ Grande Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy

    C Vener, C Annaloro & G Lambertenghi Deliliers

  3. INSERM, U871, Lyon, France

    C Pichoud & F Zoulim

  4. Université Lyon 1, Lyon, France

    C Pichoud & F Zoulim

  5. Hospices Civils de Lyon, Hôtel Dieu, Service d’Hépatologie et de Gastroentérologie, Lyon, France

    C Pichoud & F Zoulim

  6. Organ and Tissue Transplantation and Immunology, Fondazione IRCCS Ca′ Grande Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy

    F Poli & M Scalamogna

Authors
  1. M Viganò
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  2. C Vener
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  6. F Zoulim
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  7. F Facchetti
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  8. F Poli
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Corresponding author

Correspondence to M Viganò.

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Competing interests

Massimo Colombo—Consulting: Bristol-Meyers-Squibb, Schering-Plough, Roche, Novartis, Gilead, Vertex. Grant and research support: Bristol-Meyers-Squibb, Schering-Plough, Roche, Novartis, Gilead, Vertex; Advisory committees: Bristol-Meyers-Squibb, Schering-Plough, Roche, Novartis, Gilead, Vertex. Speaking and teaching: Bristol-Meyers-Squibb, Schering-Plough, Roche, Novartis, Gilead, Vertex

Pietro Lampertico—Advisory board/speaker bureau: Bristol-Meyers-Squibb, Roche, Novartis, Gilead, GSK.

The other authors have no conflict of interest.

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Viganò, M., Vener, C., Lampertico, P. et al. Risk of hepatitis B surface antigen seroreversion after allogeneic hematopoietic SCT. Bone Marrow Transplant 46, 125–131 (2011). https://doi.org/10.1038/bmt.2010.70

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