Hepatitis B Reactivation and Vaccination Effectiveness after Solid Organ Transplantation: A Matched Case-Control...

Area of Science:

• Hepatology
• Immunology
• Transplantation Medicine

Background:

• Solid organ transplant (SOT) recipients with resolved Hepatitis B virus (HBV) infection face a significant risk of HBV reactivation (HBVr).
• Limited data exists on risk factors for HBVr and the effectiveness of HBV vaccination in this vulnerable patient population.
• Understanding these factors is crucial for preventing HBVr and improving outcomes post-transplantation.

Purpose of the Study:

• To identify risk factors associated with HBVr in SOT recipients with resolved HBV infection.
• To evaluate the seroconversion rates and effectiveness of HBV vaccination administered after transplantation.
• To inform strategies for mitigating HBVr risk in SOT recipients.

Main Methods:

• Retrospective analysis of 1299 SOT recipients with resolved HBV infection.
• Case-control matching of patients who experienced HBVr with those who did not.
• Assessment of pre-transplant HBV surface antibody (anti-HBs) status and post-transplant outcomes, including allograft rejection and vaccination response.

Main Results:

• Thirty-nine out of 1299 SOT recipients experienced HBVr.
• Pre-transplant anti-HBs negativity and allograft rejection within 3 months post-transplant were independently associated with HBVr.
• In 17 vaccinated patients, 76.5% achieved seroconversion (positive anti-HBs).

Conclusions:

• Pre-transplant anti-HBs status and early allograft rejection are significant risk factors for HBVr in SOT recipients with resolved HBV infection.
• Post-transplant HBV vaccination demonstrates a high seroconversion rate, suggesting its utility in reducing HBVr risk.
• HBV vaccination should be strongly considered for SOT recipients to prevent reactivation.