Allografted recipients immunized against hepatitis B virus are at high risk of gradual surface antibody (HbsAb) disappearance post transplant, regardless of adoptive immunity transfer.
Immunized against hepatitis B virus (HBV) recipients are at risk of developing HBV postallogeneic stem cell transplantation because of the potential loss of their HBV immunity. The aim of the study was to evaluate: (1) the HbsAb eradication incidence posttransplant and potential risk factors, (2) the impact of donor's immunity on HbsAb loss, (3) the incidence of hepatitis B in patients with HbsAb disappearance. We studied, retrospectively, in 26 vaccinated and 56 naturally immunized recipients, the posttransplant HbsAb titers for a median period of 36 (6-132) months. The probability of HbsAb loss and HBV-related hepatitis was determined in all recipients. The impact of donor's immunity origin in the HBsAb disappearance was evaluated in the subgroup of, actively or naturally, immunized recipients/donors pairs. The 5-year probability of HbsAb disappearance was 90% for all patients with 18% probability of developing hepatitis at 12 years, for those who lost HbsAb. Marrow graft, antithymocyte globulin administration, age<30 years and chronic graft-versus-host disease were significant risk factors for HbsAb loss. In the subgroup of immunized recipients/donors, the donor's active immunization significantly affected this loss. Allotransplanted patients are at high risk of losing protection against HBV. The adoptive transfer of active HBV immunity does not seem to offer sustained protection posttransplant.
Kaloyannidis
Panayotis
P
Hematology Department, BMT-Unit, George Papanicolaou Hospital, Thessaloniki, Greece. eyannaki@u.washington.edu
Batsis
Ioannis
I
Yannaki
Evangelia
E
Adamidou
Despina
D
Bartzoudis
Dimitrios
D
Papathanasiou
Maria
M
Mallouri
Despina
D
Sakellari
Ioanna
I
Fassas
Athanasios
A
Anagnostopoulos
Achilles
A
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006509:Hepatitis B / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood; D017325:Hepatitis B Vaccines; D006515:Hepatitis B virus / Q000276:immunology*; D006801:Humans; D016233:Immunotherapy, Active; D016219:Immunotherapy, Adoptive; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous; D017211:Treatment Failure
D006510:Hepatitis B Antibodies; D017325:Hepatitis B Vaccines