Clearance of hepatitis B surface antigen after bone marrow transplantation: role of adoptive immunity transfer.
Adoptive immunity transfer has been reported to be effective in clearing chronic hepatitis B virus (HBV) infection. Two hundred twenty-six patients who received allogeneic bone marrow transplantation (BMT) between May 1990 and September 1995 were screened for hepatitis B markers. Twenty-one patients were hepatitis B surface antigen (HBsAg) positive before BMT. The median follow-up period was 20 months (range, 2-59 months). Two of these patients had sustained clearance of HBV infection after transplantation. Both patients were hepatitis B e antigen (HBeAg)-negative, hepatitis B e antibody (anti-HBe)-positive, and serum HBV DNA-negative (by dot-blot hybridization) before BMT. Both had a flare in the serum alanine transaminase (ALT) level around the time of HBsAg clearance. Sustained clearance of HBsAg was observed in 2 of the 5 patients who received hepatitis B surface antibody (anti-HBs)-positive marrow but in none of the 16 patients who received anti-HBs-negative marrow (P < .05). One additional patient who received anti-HBs-positive marrow had transient HBsAg seroconversion. Among the 18 patients who remained persistently HBsAg-positive after BMT, 3 had HBeAg seroconversion and 3 had reversion to HBeAg positivity. In this study, we found a significant association between clearance of HBV infection and anti-HBs-positive bone marrow donors. Adoptive immunity transfer is effective in clearing HBV from patients with chronic HBV infection.
Lau
G K
GK
Department of Medicine, Queen Mary Hospital, Hong Kong.
Lok
A S
AS
Liang
R H
RH
Lai
C L
CL
Chiu
E K
EK
Lau
Y L
YL
Lam
S K
SK
D000293:Adolescent; D019264:Adoptive Transfer; D000328:Adult; D001853:Bone Marrow / Q000276:immunology; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006510:Hepatitis B Antibodies / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D014019:Tissue Donors; D016896:Treatment Outcome
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens