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- Publisher Website: 10.1002/hep.29022
- Scopus: eid_2-s2.0-85016436690
- PMID: 28027590
- WOS: WOS:000399459800004
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Article: Hepatitis B reactivation in occult viral carriers undergoing hematopoietic stem cell transplantation: A prospective study
Title | Hepatitis B reactivation in occult viral carriers undergoing hematopoietic stem cell transplantation: A prospective study |
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Authors | |
Issue Date | 2017 |
Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ |
Citation | Hepatology, 2017, v. 65 n. 5, p. 1451-1461 How to Cite? |
Abstract | Hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)–negative, antibody to hepatitis B core antigen (anti‐HBc)–positive patients after allogeneic hematopoietic stem cell transplantation (HSCT) has not been prospectively studied. HBsAg‐negative, anti‐HBc–positive patients with undetectable HBV DNA undergoing allogeneic HSCT were prospectively monitored every 4 weeks. The primary endpoint was HBV reactivation, defined as detectable HBV DNA (≥10 IU/mL). Secondary endpoints included overall survival, HBsAg positivity, and changes in liver biochemistry and antibody to HBsAg levels. Among 297 allogeneic HSCT recipients, 85 (28.7%) were HBsAg‐negative, anti‐HBc–positive, of whom 62 were recruited and monitored for a median of 48 (4‐104) weeks. The 2‐year cumulative HBV DNA detectability rate was 40.8%, occurring at a median of 44 (8‐100) weeks. Multivariate analysis showed that age ≥50 years (P = 0.004, hazard ratio = 8.2) and chronic graft‐versus‐host disease (P = 0.010, hazard ratio = 5.3) were significantly associated with HBV reactivation. Other clinical parameters, including baseline antibody to HBsAg status, serial changes in antibody to HBsAg levels, and donor serology, were not associated with HBV reactivation. Patients <50 years old and without chronic graft‐versus‐host disease, compared with the remaining patient cohort, had a significantly lower 2‐year cumulative HBV reactivation rate (5.6% versus 65.0%, P = 0.004). Entecavir successfully suppressed HBV DNA to undetectable levels, with no cases developing biochemical hepatitis. Conclusion: HBsAg‐negative, anti‐HBc–positive patients had a high rate of HBV reactivation after allogeneic HSCT, with determinants of HBV reactivation including age ≥50 years and chronic graft‐versus‐host disease; treatment strategies based on these parameters may prevent HBV reactivation and subsequent complications. (ClinicalTrials.gov identifier NCT01481649.) (Hepatology 2017;65:1451‐1461). |
Persistent Identifier | http://hdl.handle.net/10722/237728 |
ISSN | 2023 Impact Factor: 12.9 2023 SCImago Journal Rankings: 5.011 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Seto, WKW | - |
dc.contributor.author | Chan, SYT | - |
dc.contributor.author | Hwang, YYG | - |
dc.contributor.author | Wong, DKH | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | Liu, SHK | - |
dc.contributor.author | Singh, GHH | - |
dc.contributor.author | Lam, YF | - |
dc.contributor.author | Lau, EHY | - |
dc.contributor.author | Cheung, KSM | - |
dc.contributor.author | Lie, AKW | - |
dc.contributor.author | Lai, CL | - |
dc.contributor.author | Kwong, YL | - |
dc.contributor.author | Yuen, RMF | - |
dc.date.accessioned | 2017-01-20T02:27:34Z | - |
dc.date.available | 2017-01-20T02:27:34Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Hepatology, 2017, v. 65 n. 5, p. 1451-1461 | - |
dc.identifier.issn | 0270-9139 | - |
dc.identifier.uri | http://hdl.handle.net/10722/237728 | - |
dc.description.abstract | Hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)–negative, antibody to hepatitis B core antigen (anti‐HBc)–positive patients after allogeneic hematopoietic stem cell transplantation (HSCT) has not been prospectively studied. HBsAg‐negative, anti‐HBc–positive patients with undetectable HBV DNA undergoing allogeneic HSCT were prospectively monitored every 4 weeks. The primary endpoint was HBV reactivation, defined as detectable HBV DNA (≥10 IU/mL). Secondary endpoints included overall survival, HBsAg positivity, and changes in liver biochemistry and antibody to HBsAg levels. Among 297 allogeneic HSCT recipients, 85 (28.7%) were HBsAg‐negative, anti‐HBc–positive, of whom 62 were recruited and monitored for a median of 48 (4‐104) weeks. The 2‐year cumulative HBV DNA detectability rate was 40.8%, occurring at a median of 44 (8‐100) weeks. Multivariate analysis showed that age ≥50 years (P = 0.004, hazard ratio = 8.2) and chronic graft‐versus‐host disease (P = 0.010, hazard ratio = 5.3) were significantly associated with HBV reactivation. Other clinical parameters, including baseline antibody to HBsAg status, serial changes in antibody to HBsAg levels, and donor serology, were not associated with HBV reactivation. Patients <50 years old and without chronic graft‐versus‐host disease, compared with the remaining patient cohort, had a significantly lower 2‐year cumulative HBV reactivation rate (5.6% versus 65.0%, P = 0.004). Entecavir successfully suppressed HBV DNA to undetectable levels, with no cases developing biochemical hepatitis. Conclusion: HBsAg‐negative, anti‐HBc–positive patients had a high rate of HBV reactivation after allogeneic HSCT, with determinants of HBV reactivation including age ≥50 years and chronic graft‐versus‐host disease; treatment strategies based on these parameters may prevent HBV reactivation and subsequent complications. (ClinicalTrials.gov identifier NCT01481649.) (Hepatology 2017;65:1451‐1461). | - |
dc.language | eng | - |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/ | - |
dc.relation.ispartof | Hepatology | - |
dc.rights | This is the peer reviewed version of the following article: Hepatology, 2017, v. 65 n. 5, p. 1451-1461, which has been published in final form at http://dx.doi.org/10.1002/hep.29022. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. | - |
dc.title | Hepatitis B reactivation in occult viral carriers undergoing hematopoietic stem cell transplantation: A prospective study | - |
dc.type | Article | - |
dc.identifier.email | Seto, WKW: wkseto2@hku.hk | - |
dc.identifier.email | Chan, SYT: drtchan@hku.hk | - |
dc.identifier.email | Hwang, YYG: yyhwang@hku.hk | - |
dc.identifier.email | Wong, DKH: danywong@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@hkucc.hku.hk | - |
dc.identifier.email | Liu, SHK: drkliu@hku.hk | - |
dc.identifier.email | Singh, GHH: gillhsh@hku.hk | - |
dc.identifier.email | Lam, YF: fyflam@hku.hk | - |
dc.identifier.email | Lau, EHY: ehylau@hku.hk | - |
dc.identifier.email | Cheung, KSM: cks634@hku.hk | - |
dc.identifier.email | Lie, AKW: akwlie@hkucc.hku.hk | - |
dc.identifier.email | Lai, CL: hrmelcl@hku.hk | - |
dc.identifier.email | Kwong, YL: ylkwong@hku.hk | - |
dc.identifier.email | Yuen, RMF: mfyuen@hku.hk | - |
dc.identifier.authority | Seto, WKW=rp01659 | - |
dc.identifier.authority | Wong, DKH=rp00492 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Singh, GHH=rp01914 | - |
dc.identifier.authority | Lau, EHY=rp01349 | - |
dc.identifier.authority | Cheung, KSM=rp02532 | - |
dc.identifier.authority | Lai, CL=rp00314 | - |
dc.identifier.authority | Kwong, YL=rp00358 | - |
dc.identifier.authority | Yuen, RMF=rp00479 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1002/hep.29022 | - |
dc.identifier.pmid | 28027590 | - |
dc.identifier.scopus | eid_2-s2.0-85016436690 | - |
dc.identifier.hkuros | 271015 | - |
dc.identifier.volume | 65 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 1451 | - |
dc.identifier.epage | 1461 | - |
dc.identifier.isi | WOS:000399459800004 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0270-9139 | - |