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Infections Post Transplant

Hepatitis B virus reactivation with clinical flare in allogeneic stem cell transplants with chronic graft-versus-host disease

Bone Marrow Transplantation volume 30, pages 189–194 (2002)Cite this article

Abstract

We conducted a retrospective study with the aim of identifying risk factors and clinical characteristics associated with HBV reactivation and clinical flare after allogeneic stem cell transplantation (aSCT). We reviewed the King Faisal Specialist Hospital and Research Center International Bone Marrow Transplant Registry database from January 1998 to June 2000. Complete serological screening for HBV was available in 128 of 131 patients transplanted during that period. Fifty-four (42%) had evidence of prior infection and recovery from HBV before transplant (hepatitis B core antibody positive, B surface antigen negative). Forty-two were evaluable for HBV reactivation and clinical flare. Six (14%) reactivated with clinical flare as documented by seroconversion and/or positive HBV DNA in the serum with biochemical hepatitis at 5.5, 18, 18, 19, 21 and 23 months post-transplant. Five of fifteen patients with chronic graft-versus-host disease (cGVHD) reactivated with clinical flare in contrast to 1/27 without cGVHD (RR: 9.0, 95% CI: 1.2–70.1 P < 0.02). HBV reactivation with clinical flare occurred during immunosuppressive therapy tapering or withdrawal in all patients. In conclusion, hepatitis B core antibody positive allogeneic stem cell recipients with cGVHD are at significant risk of HBV reactivation with clinical flare.

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Acknowledgements

We are indebted to all physicians of the Adult Hematology/BMT Section and nursing staff who provided care for all these patients. We are grateful to Drs Robert Stuart and Michael Loubser for critically reviewing the manuscript.

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Authors and Affiliations

  1. Department of Oncology, Section of Adult Hematology/BMT, King Faisal Specialist Hospital and Research Center Health Care System, Riyadh, Saudi Arabia

    P Seth, E Sahovic, M Aljurf & M Gyger

  2. Department of Medicine, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center Health Care System, Riyadh, Saudi Arabia

    AA Alrajhi

  3. Department of Gastroenterology, King Faisal Specialist Hospital and Research Center Health Care System, Riyadh, Saudi Arabia

    I Kagevi

  4. Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center Health Care System, Riyadh, Saudi Arabia

    MA Chaudhary

  5. Oncology Data Unit, King Faisal Specialist Hospital and Research Center Health Care System, Riyadh, Saudi Arabia

    E Colcol

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Seth, P., Alrajhi, A., Kagevi, I. et al. Hepatitis B virus reactivation with clinical flare in allogeneic stem cell transplants with chronic graft-versus-host disease. Bone Marrow Transplant 30, 189–194 (2002). https://doi.org/10.1038/sj.bmt.1703614

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