A long-term follow-up study on hepatitis B surface antigen-positive patients undergoing allogeneic hematopoietic stem cell transplantation.
The long-term hepatic complications after allogeneic hematopoietic stem cell transplantation (HSCT) in hepatitis B virus (HBV) endemic area are unknown. We examined the serological and liver-related outcome of 803 consecutive patients who received allogeneic HSCTs, with a median follow-up period of 83 months (range, 0.5-155 months). Late HBV-related hepatitis occurred in 2 of the 721 hepatitis B surface antigen-negative (HBsAg-) recipients compared with 16 of the 82 HBsAg+ recipients after HSCT (0.3% vs 19.5%; P < .001 by log-rank). Liver cirrhosis developed in 8 of the 82 HBsAg+ recipients compared with none of the 721 HBsAg- recipients (9.8% vs 0%; P < .001 by log-rank). Twenty of the 31 (64.5%) HBsAg+ recipients of hematopoietic stem cells from donors with natural immunity to HBV had sustained serologic clearance of HBsAg after HSCT. Eight of the 62 recipients without sustained HBsAg clearance compared with none of the 20 recipients with sustained HBsAg clearance developed liver cirrhosis (12.9% vs 0%; P = .02 by log-rank). Our study showed that long-term hepatic complications occur in a significant proportion of HBsAg+ patients after HSCT and the incidence of liver cirrhosis is reduced in those with sustained serologic clearance of HBsAg after HSCT.
Hui
Chee-Kin
CK
Division of Gastroenterology and Hepatology, The University of Hong Kong, SAR, China.
Lie
Albert
A
Au
Wing-Yan
WY
Leung
Yu-Hung
YH
Ma
Shing-Yan
SY
Cheung
Winnie W W
WW
Zhang
Hai-Ying
HY
Chim
Chor-Sum
CS
Kwong
Yok-Lam
YL
Liang
Raymond
R
Lau
George K K
GK
D000293:Adolescent; D019264:Adoptive Transfer; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000378:metabolism*; D019694:Hepatitis B, Chronic / Q000209:etiology / Q000276:immunology / Q000635:transmission; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous
D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens