Progressive disappearance of anti-hepatitis B surface antigen antibody and reverse seroconversion after allogeneic hematopoietic stem cell transplantation in patients with previous hepatitis B virus infection.
Reactivation of resolved hepatitis B virus (HBV) infection, which is known as reverse seroconversion (RS), has been reported as a rare complication of allogeneic hematopoietic stem cell transplantation. We retrospectively studied HBV serologic markers in 14 recipients with pretransplant anti-hepatitis B surface antigen antibody (anti-HBs). Progressive decreases in anti-HBs titer were observed in all cases. In 12 cases, anti-HBs titer had decreased to under the protective value. RS occurred in seven cases after disappearance of anti-HBs. Although reseroconversion occurred in five cases, two cases remained in an HBV-carrier status after resolution of hepatitis. In the other five cases, RS did not occur even after disappearance of anti-HBs. The actual risks of anti-HBs disappearance and RS were estimated to be 75.0% and 39.8% at 2 years and 100.0% and 70.0% at 5 years, respectively. In conclusion, RS is a late-onset complication with high frequency that can be predicted by careful monitoring of progressive decrease in anti-HBs titer.
Onozawa
Masahiro
M
Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. masahiro.onozawa@nifty.ne.jp
Hashino
Satoshi
S
Izumiyama
Koh
K
Kahata
Kaoru
K
Chuma
Makoto
M
Mori
Akio
A
Kondo
Takeshi
T
Toyoshima
Nobuyasu
N
Ota
Shuichi
S
Kobayashi
Sumiko
S
Hige
Shuhei
S
Toubai
Tomomi
T
Tanaka
Junji
J
Imamura
Masahiro
M
Asaka
Masahiro
M
D000328:Adult; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006509:Hepatitis B / Q000276:immunology*; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006801:Humans; D007114:Immunization; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens