Hepatic events after bone marrow transplantation in patients with hepatitis B infection: a case controlled study.
Hepatitis B reactivation following chemotherapy withdrawal may result in hepatitis, hepatic failure and death. We studied the clinical outcome and the causes of hepatic events of hepatitis B surface antigen positive recipients undergoing bone marrow transplantation. Twenty-four hepatitis B surface antigen patients were matched with 24 hepatitis B surface antigen negative patients for age, sex, CMV positive serology, underlying hematological disease and type of bone marrow transplantation. Post-BMT, there were 18 patients in the hepatitis B surface antigen positive group and four patients in the hepatitis B surface antigen negative group who suffered from hepatitis (P < 0.05). Thirteen of the 18 hepatitis were related to HBV reactivation in the hepatitis B surface antigen positive group and none of the four hepatitis in the hepatitis B surface antigen negative group (P = 0.01). The hepatitis B surface antigen positive group also had an increased incidence of acute graft-versus-host disease of liver (6 vs 1, P = 0.03). However, there was no significant increase in the incidence of veno-occlusive disease (10 vs 7, P = 0.40) and persistent hepatitis (3 vs 0, P = 0.07) in the hepatitis B surface antigen positive group. Using the log-rank test, there was no significant difference in survival between the hepatitis B surface antigen positive and negative recipients.
Lau
G K
GK
Department of Medicine, Queen Mary Hospital, Hong Kong.
Liang
R
R
Chiu
E K
EK
Lee
C K
CK
Lam
S K
SK
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016022:Case-Control Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006521:Hepatitis, Chronic / Q000209:etiology; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000628:therapy*; D017093:Liver Failure / Q000209:etiology; D008297:Male; D012008:Recurrence
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens