Hepatitis B serological changes following allogeneic bone marrow transplantation

Area of Science:

• Immunology
• Hepatology
• Transplantation

Background:

• Hepatitis B virus (HBV) reverse seroconversion (RS) is increasingly reported in immunocompromised patients post-allogeneic hematopoietic stem cell transplant (allo-HSCT).
• Patients with prior HBV infection (HBsAg negative, anti-HBc positive) are at risk for RS after allo-HSCT.

Purpose of the Study:

• To review Hepatitis B serological testing in patients undergoing allo-HSCT.
• To identify the frequency and patterns of HBV serological marker changes, including RS, post-transplant.

Main Methods:

• Retrospective review of serial HBV serological testing.
• Analysis of patients who underwent allo-HSCT between 2000 and 2006.
• Identification of patients with serological evidence of past HBV infection.

Main Results:

• One case of HBV reverse seroconversion was identified among 12 patients with prior HBV infection.
• Five patients showed declining Hepatitis B surface antibody levels post-transplant.
• Four patients lost their anti-HBc antibody, and 14 developed isolated anti-HBc post-transplant.

Conclusions:

• Close monitoring of HBV serological markers, including anti-HBsAb and anti-HBcAb, is essential in allo-HSCT recipients and donors.
• Monitoring HBV DNA levels pre- and post-transplant aids in early detection of RS and new HBV acquisition.
• Proactive monitoring strategies can facilitate timely treatment and management of HBV reactivation post-allo-HSCT.