2015, Number 2
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Ann Hepatol 2015; 14 (2)
Prospective study of hepatitis B virus reactivation in patients with hematological malignancies
Pompili M, Basso M, Hohaus S, Bosco G, Nosotti L, D’Andrea M, Fenu S, Grieco A, Laurenti L, Mirisola C, Pagano L, Rapaccini GL, Sica S, Storti S, Landolfi R
Language: English
References: 22
Page: 168-174
PDF size: 94.85 Kb.
ABSTRACT
Background and aim. The best strategy for managing patients with resolved hepatitis B virus infection
(HBsAg negative, anti-HBc antibodies positive with or without anti-HBs antibodies) and hematological
malignancies under immunosuppressive therapies has not been defined. The aim of this study was to
prospectively analyze the risk of hepatitis B virus reactivation in these patients.
Material and
methods. Twenty-three patients (20 positive for anti-HBs) were enrolled. Eleven patients underwent
hematopoietic stem cell transplantation (autologous in 7 cases, allogeneic in 4 cases) while the remaining
12 were treated with immunosuppressive regimens (including rituximab in 9 cases).
Results. During
the study no patient presented acute hepatitis. However, three anti-HBc/anti-HBs positive patients
who were treated with allogeneic hematopoietic stem cell transplantation demonstrated hepatitis B
virus reactivation within 12 months from transplant. No one of the remaining patients showed hepatitis
B virus reverse seroconversion.
Conclusions. Allogeneic hematopoietic stem cell transplantation is a
high risk condition for late hepatitis B virus reactivation in patients with resolved infection. Reverse
seroconversion seems to be a rare event in anti-HBc/anti-HBs positive patients submitted to autologous
hematopoietic stem cell transplantation or systemic chemotherapy with or without rituximab.
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