title: Prospective study of hepatitis B virus reactivation in patients with hematological malignancies.
abstract: OBJECTIVE
  The best strategy for managing patients with resolved hepatitis B virus infection (HBsAg negative, anti-HBc antibodies positive with or without anti-HBs antibodies) and hematological malignancies under immunosuppressive therapies has not been defined. The aim of this study was to prospectively analyze the risk of hepatitis B virus reactivation in these patients.
  
  
  METHODS
  Twenty-three patients (20 positive for anti-HBs) were enrolled. Eleven patients underwent hematopoietic stem cell transplantation (autologous in 7 cases, allogeneic in 4 cases) while the remaining 12 were treated with immunosuppressive regimens (including rituximab in 9 cases).
  
  
  RESULTS
  During the study no patient presented acute hepatitis. However, three anti-HBc/anti-HBs positive patients who were treated with allogeneic hematopoietic stem cell transplantation demonstrated hepatitis B virus reactivation within 12 months from transplant. No one of the remaining patients showed hepatitis B virus reverse seroconversion.
  
  
  CONCLUSIONS
  Allogeneic hematopoietic stem cell transplantation is a high risk condition for late hepatitis B virus reactivation in patients with resolved infection. Reverse seroconversion seems to be a rare event in anti-HBc/anti-HBs positive patients submitted to autologous hematopoietic stem cell transplantation or systemic chemotherapy with or without rituximab.
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Maurizio
authors: M
authors: Pompili
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Maria
authors: M
authors: Basso
authors: Department of Hematology Catholic University of Sacred Heart, Rome, Italy.
authors: Stefan
authors: S
authors: Hohaus
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Giulia
authors: G
authors: Bosco
authors: National Institute for Health. Migration and Poverty (NIHMP), Rome, Italy.
authors: Lorenzo
authors: L
authors: Nosotti
authors: National Institute for Health. Migration and Poverty (NIHMP), Rome, Italy.
authors: Mariella
authors: M
authors: D'Andrea
authors: Department of Hematology. San Giovanni Addolorata Hospital, Rome, Italy.
authors: Susanna
authors: S
authors: Fenu
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Antonio
authors: A
authors: Grieco
authors: Department of Hematology Catholic University of Sacred Heart, Rome, Italy.
authors: Luca
authors: L
authors: Laurenti
authors: National Institute for Health. Migration and Poverty (NIHMP), Rome, Italy.
authors: Concetta
authors: C
authors: Mirisola
authors: Department of Hematology Catholic University of Sacred Heart, Rome, Italy.
authors: Livio
authors: L
authors: Pagano
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Gian Ludovico
authors: GL
authors: Rapaccini
authors: Department of Hematology Catholic University of Sacred Heart, Rome, Italy.
authors: Simona
authors: S
authors: Sica
authors: Department of Hematology Catholic University of Sacred Heart, Rome, Italy.
authors: Sergio
authors: S
authors: Storti
authors: Department of Internal Medicine Catholic University of Sacred Heart, Rome, Italy.
authors: Raffaele
authors: R
authors: Landolfi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000097:blood; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000821:virology*; D006510:Hepatitis B Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D014775:Virus Activation
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens; D007166:Immunosuppressive Agents