title: Hepatitis B-related serological events in hematopoietic stem cell transplant patients and efficacy of lamivudine prophylaxis against reactivation.
abstract: Reactivation of remote hepatitis B infection (RHBI) is an important cause of morbidity in hematopoietic cell transplant (HCT) patients. We analyzed the prevalence of RHBI in 205 patients who underwent HCT in our centre, serological events related to hepatitis B virus (HBV) reactivation and role of lamivudine prophylaxis in HCT patients with RHBI. The prevalence of RHBI was 14% (28/205 patients). Of these 28 patients, 15 received lamivudine prophylaxis (14 anti-HBcIgG positive and 1 only anti-HBs positive) while 13 did not receive lamivudine prophylaxis (12 anti-HBs positive and 1 anti-HBcIgG positive). None in prophylaxis group developed HBV reactivation while 12 of 13 in no-prophylaxis group reactivated (P < 0.001). The rate of HBV reactivation was 10% (21/205 patients), which included 9 patients with no evidence of RHBI pre-transplant. We conclude that lamivudine prophylaxis protects against HBV reactivation in HCT patients with evidence of RHBI. Lamivudine prophylaxis should be used not only in patients with anti-HBcIgG positivity but also in those with isolated anti-HBs positivity pre-transplant given the high rate of HBV reactivation in these patients. HBV serology cannot identify all cases with RHBI and therefore does not preclude HBV reactivation post-transplant. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Punatar
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Jayant
authors.initials: J
authors.lastname: Gawande
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Bhausaheb
authors.initials: B
authors.lastname: Bagal
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Libin
authors.initials: L
authors.lastname: Mathew
authors.affiliation: Department of Microbiology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Bhat
authors.affiliation: Department of Biostatistics, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Sadhana
authors.initials: S
authors.lastname: Kannan
authors.affiliation: Bone Marrow Transplant Unit, Department of Medical Oncology, ACTREC, Tata Memorial Centre, Mumbai, India.
authors.forename: Navin
authors.initials: N
authors.lastname: Khattry
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D064592:Autografts; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006509:Hepatitis B / Q000188:drug therapy*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D007223:Infant; D019259:Lamivudine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy* / Q000821:virology; D014775:Virus Activation / Q000187:drug effects*
chemical_list: D019259:Lamivudine
keywords: HBV reactivation; hematopoietic stem cell transplantation; hepatitis B virus; lamivudine prophylaxis; remote HBV infection