Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

The impact of hepatitis B core antibody levels on HBV reactivation after allogeneic hematopoietic SCT: an 11-year experience at a single center

Bone Marrow Transplantation volume 51, pages 1496–1498 (2016)Cite this article

Subjects

In Japan, 970000 people (0.63%) are infected with HBV, as estimated by hepatitis B surface Ag (HBsAg) testing in blood donors.1 HBV reactivation has been reported in 11–86% of allogeneic hematopoietic stem cell transplantation (HSCT) recipients with resolved HBV infection, mainly in those receiving stem cells from an anti-HBs-negative donor, with baseline anti-HBs<10 mIU/mL and the development of chronic GvHD (cGvHD), requiring tapering or withdrawal of immunosuppressive therapy to treat GvHD.2, 3, 4, 5 However, the risk factors for HBV reactivation after HSCT remain unclear. In the present study, we assessed the predictive factors in a cohort of patients with resolved HBV infection who subsequently underwent allogeneic HSCT.

A retrospective review of the HSCT database was performed for patients who underwent allogeneic HSCT between January 2003 and October 2014 at Hamanomachi Hospital. Patients were identified as having resolved HBV infection if they were HBsAg-negative, anti-HBc and/or anti-HBs-positive. No patient had been vaccinated for HBV before and after HSCT. The patients who were not followed up for at least 6 months were excluded from this study. To identify predictors of HBV reactivation after allogenic HSCT, the medical records were reviewed for covariates and outcomes of interest (Tables 1a and 1b). Patient data were censored at death or on 31 August 2015. The study protocol complied with the Good Clinical Practice Guidelines and the 1975 Declaration of Helsinki and was approved by the office for Human Research Studies at Hamanomachi Hospital.

Table 1a Univariate analysis of risk factors associated with HBV reactivation after allogeneic HSCT
Full size table
Table 1b Multivariate analysis of risk factors associated with HBV reactivation after allogeneic HSCT: forward selection method
Full size table

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Tanaka J, Kumagai J, Katayama K, Komiya Y, Mizui M, Yamanaka R et al. Sex- and age-specific carriers of hepatitis B and C viruses in Japan estimated by the prevalence in the 3,485,648 first-time blood donors during 1995-2000. Intervirology 2004; 47: 32–40.

    Article  Google Scholar 

  2. Knöll A, Boehm S, Hahn J, Holler E, Jilg W . Reactivation of resolved hepatitis B virus infection after allogeneic haematopoietic stem cell transplantation. Bone Marrow Transplant 2004; 33: 925–929.

    Article  Google Scholar 

  3. Dhédin N, Douvin C, Kuentz M, Saint Marc MF, Reman O, Rieux C et al. Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-HBs and anti-HBc. Transplantation 1998; 66: 616–619.

    Article  Google Scholar 

  4. Hammond SP, Borchelt AM, Ukomadu C, Ho VT, Baden LR, Marty FM . Hepatitis B virus reactivation following allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2009; 15: 1049–1059.

    Article  Google Scholar 

  5. Seth P, Alrajhi AA, Kagevi I, Chaudhary MA, Colcol E, Sahovic E et al. Hepatitis B virus reactivation with clinical flare in allogeneic stem cell transplants with chronic graft-versus-host disease. Bone Marrow Transplant 2002; 30: 189–194.

    Article  CAS  Google Scholar 

  6. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 1995; 15: 825–828.

    CAS  Google Scholar 

  7. Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 2005; 11: 945–956.

    Article  Google Scholar 

  8. Hoofnagle JH, Gerety RJ, Ni LY, Barker LF . Antibody to hepatitis B core antigen. A sensitive indicator of hepatitis B virus replication. N Engl J Med 1974; 290: 1336–1340.

    Article  CAS  Google Scholar 

  9. Yuan Q, Song L-W, Liu C-J, Li Z, Liu P-G, Huang C-H et al. Quantitative hepatitis B core antibody level may help predict treatment response in chronic hepatitis B patients. Gut 2013; 62: 182–184.

    Article  CAS  Google Scholar 

  10. Fan R, Sun J, Yuan Q, Xie Q, Bai X, Ning Q et al. Baseline quantitative hepatitis B core antibody titre alone strongly predicts HBeAg seroconversion across chronic hepatitis B patients treated with peginterferon or nucleos(t)ide analogues. Gut 2016; 65: 313–320.

    Article  CAS  Google Scholar 

  11. Chang JJ, Lewin SR . Immunopathogenesis of hepatitis B virus infection. Immunol Cell Biol 2007; 85: 16–23.

    Article  CAS  Google Scholar 

  12. Farci P, Diaz G, Chen Z, Govindarajan S, Tice A, Agulto L et al. B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure. Proc Natl Acad Sci USA 2010; 107: 8766–8771.

    Article  CAS  Google Scholar 

  13. Hou F-Q, Song L-W, Yuan Q, Fang L-L, Ge S-X, Zhang J et al. Quantitative hepatitis B core antibody level is a new predictor for treatment response in HBeAg-positive chronic hepatitis B patients receiving peginterferon. Theranostics 2015; 5: 218–226.

    Article  CAS  Google Scholar 

  14. Kobyashi M, Chayama K, Arase Y, Tsubota A, Saitoh S, Suzuki Y et al. Progressive and sufficient decrease of hepatitis B core antibody can predict the disappearance of hepatitis B virus DNA in Japanese patients with hepatitis B surface antigen clearance. J Gastroenterol 2000; 35: 753–757.

    Article  CAS  Google Scholar 

  15. Hwang JP, Lok AS-F . Management of patients with hepatitis B who require immunosuppressive therapy. Nat Rev Gastroenterol Hepatol 2014; 11: 209–219.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to Yukari Mikajiri and Megumi Naganuma for their valuable support in the preparation of this manuscript.

Author information

Authors and Affiliations

  1. The Center for Liver Disease, Hamanomachi Hospital, Fukuoka, Japan

    S K Bae, T Gushima & K Takahashi

  2. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    N Saito, I Yamanaka, T Shimokawa, Y Matsuo, S Yoshida, I Kawano, H Henzan & T Eto

  3. Medicine and Biosystemic Science, Kyushu University, Fukuoka, Japan

    S Shimoda

Authors
  1. S K Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Gushima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N Saito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I Yamanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T Shimokawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. I Kawano
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H Henzan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S Shimoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. T Eto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. K Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S K Bae.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bae, S., Gushima, T., Saito, N. et al. The impact of hepatitis B core antibody levels on HBV reactivation after allogeneic hematopoietic SCT: an 11-year experience at a single center. Bone Marrow Transplant 51, 1496–1498 (2016). https://doi.org/10.1038/bmt.2016.149

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2016.149

This article is cited by

Search

Advanced search

Quick links