title: Considerable decrease in antibodies against hepatitis B surface antigen following kidney transplantation.
abstract: BACKGROUND
  Immunization against hepatitis B virus (HBV) in kidney transplantation (KT) candidates and recipients is recommended. If anti-HBV surface antigen antibody (anti-HBsAb) titer of 10 IU/L is admitted to be protective, the optimal threshold, at and after KT, is unknown. In addition, the natural evolution of anti-HBsAb titers after KT is not reported.
  
  
  OBJECTIVE
  To describe rates of protective immunity to HBV at time of KT (baseline) and evolution of anti-HBsAb titers during the following year.
  
  
  METHODS
  We retrospectively analyzed HBV serology at baseline, 15 days, and 4 and 12 months post-KT. No patient received vaccination during the study period, but information about previous vaccination was unavailable.
  
  
  RESULTS
  At baseline 80% of 141 recipients had anti-HBsAb titer ≥10 IU/L. Among these 113 patients, 84 had subsequent HBV serologies at day 15 and month 4, and 67 had also serology at month 12. At month 12, 25% of patients had lost protective anti-HBsAb titers (p<0.001). The duration of protective anti-HBsAb titers was significantly longer when the initial titer was ≥ 100 IU/L versus <100 IU/L (log-rank test p<0.0001). Protective titers at month 12 persisted in 93% of patients with initial titer ≥100 IU/L compared to 33% with 10-100IU/L titer (p<0.0001). In contrast, duration of protective titers did not differ according to the anti-HBV core antigen antibody status at baseline.
  
  
  CONCLUSIONS
  Despite a high prevalence of protective anti-HBsAb titer at KT, the loss of protective immunity during the following year was considerable, particularly when initial anti-HBsAb titer was <100 IU/L.
authors.affiliation: Centre de Néphrologie et Transplantation Rénale, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Conception, 147 boulevard Baille, 13385 Marseille CEDEX 05, France; URMITE, UM63 CNRS 7278 IRD 198, Aix-Marseille Univ., Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France. Electronic address: vmoal@ap-hm.fr.
authors.forename: Valérie
authors.initials: V
authors.lastname: Moal
authors.affiliation: Fondation IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France. Electronic address: anne.motte@ap-hm.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Motte
authors.affiliation: Centre de Néphrologie et Transplantation Rénale, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Conception, 147 boulevard Baille, 13385 Marseille CEDEX 05, France; Aix-Marseille Univ., 13284, Marseille, France. Electronic address: Henri.VACHERCOPONAT@ap-hm.fr.
authors.forename: Henri
authors.initials: H
authors.lastname: Vacher-Coponat
authors.affiliation: Fondation IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France. Electronic address: catherine.tamalet@ap-hm.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tamalet
authors.affiliation: Centre de Néphrologie et Transplantation Rénale, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Conception, 147 boulevard Baille, 13385 Marseille CEDEX 05, France; Aix-Marseille Univ., 13284, Marseille, France. Electronic address: yvon.berland@ap-hm.fr.
authors.forename: Yvon
authors.initials: Y
authors.lastname: Berland
authors.affiliation: URMITE, UM63 CNRS 7278 IRD 198, Aix-Marseille Univ., Faculté de Médecine, 27 boulevard Jean Moulin, 13385 Marseille CEDEX 05, France; Fondation IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie, Assistance Publique - Hôpitaux de Marseille, Centre Hospitalo-Universitaire Timone 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France. Electronic address: philippe.colson@univ-amu.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Colson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control; D006510:Hepatitis B Antibodies / Q000097:blood*; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D006801:Humans; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D006510:Hepatitis B Antibodies; D006514:Hepatitis B Surface Antigens
keywords: Anti-HBs antibody; HBV seroreversion; Hepatitis B virus; Kidney transplantation; Recipient