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Conference Paper: A prospective study of hepatitis B reactivation in patients with prior HBV exposure undergoing hematopoietic stem cell transplantation: reactivation association with graft-versus-host disease

TitleA prospective study of hepatitis B reactivation in patients with prior HBV exposure undergoing hematopoietic stem cell transplantation: reactivation association with graft-versus-host disease
Authors
KeywordsMedical sciences
Gastroenterology
Issue Date2015
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
The 50th Annual Meeting of the European Association for the Study of the Liver (International Liver Congress™ 2015), Vienna, Austria, 22-26 April 2015. In Journal of Hepatology, 2015, v. 62 suppl. 2, p. S194, abstract no. O009 How to Cite?
AbstractBACKGROUND AND AIMS: Patterns of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-negative, antibody to the hepatitis B core antigen (anti-HBc)-positive individuals undergoing hematopoietic stem cell transplantation (HSCT) have not been well described. METHODS: From September 2011 onwards, we recruited treatmentnaive HBsAg-negative, anti-HBc-positive patients with baseline undetectable serum HBVDNA (<10 IU/mL), undergoing either autologous or allogenic HSCT. For allogenic HSCT, only recipients whose donors were HBsAg-negative were recruited. Liver biochemistry, serum HBVDNA, HBsAg and antibody to HBsAg (anti-HBs) were prospectively monitoring every 4 weeks after HSCT up to 2 years. Following guidelines from the European Association for the Study of the Liver, entecavir was started when HBV reactivation, defined as detectable HBVDNA (≥10 IU/mL) was encountered. RESULTS: At the time of writing, among 328 patients undergoing HSCT, 89 (27.3%) were HBsAg-negative, anti-HBc-positive, of whom 67 (75.3%) fulfilled our inclusion criteria and were recruited. The median duration of follow-up was 52 (range 4–104) weeks. The 2-year cumulative HBV reactivation rate, calculated using the Kaplan–Meier method, was 36.8%. Thirteen patients developed reactivation after a median duration of 44 (range 8–100) weeks, of whom 11 patients (84.6%) remained HBsAg-negative at reactivation. Median HBVDNA level at reactivation was 24.8 (range 14.6–428) IU/mL. Patients with acute and/or chronic graft-versus-host-disease (GVHD) had a significantly higher 2-year cumulative rate of HBV reactivation than those without (acute GVHD: 78.8% versus 22.4%, p = 0.006; chronic GVHD: 83.8% versus 23.3%, p < 0.001). Other clinical parameters, including age, anti-HBs status, and donor serology had no association with HBV reactivation (all p > 0.05). Multivariate Cox regression analysis showed that chronic GVHD was the only factor independently associated with reactivation (p = 0.030, hazard ratio 3.9, 95% confidence interval 1.1–13.8). Entecavir treatment successfully controlled HBV reactivation in all cases. CONCLUSIONS: From this interim analysis, a substantial proportion of HBsAg-negative, anti-HBc-positive patients developed HBV reactivation after HSCT, with risk of reactivation significantly higher in patients with chronic GVHD. Periodic HBVDNA monitoring was an effective strategy in preventing HBV-related complications.
DescriptionOral Presentation - General viral hepatitis: no. O009
This journal suppl. entitled: Abstracts of The International Liver Congress™ 2015 - 50 Annual meeting of the European Association for the Study of the Liver
Persistent Identifierhttp://hdl.handle.net/10722/214867
ISSN
2015 Impact Factor: 10.59
2015 SCImago Journal Rankings: 4.570

 

DC FieldValueLanguage
dc.contributor.authorSeto, WK-
dc.contributor.authorChan, TSY-
dc.contributor.authorHwang, YY-
dc.contributor.authorWong, DKH-
dc.contributor.authorLiu, KSH-
dc.contributor.authorSingh, GHH-
dc.contributor.authorLam, YF-
dc.contributor.authorFung, J-
dc.contributor.authorLie, AKW-
dc.contributor.authorLai, CL-
dc.contributor.authorKwong, YL-
dc.contributor.authorYuen, MF-
dc.date.accessioned2015-08-21T11:59:42Z-
dc.date.available2015-08-21T11:59:42Z-
dc.date.issued2015-
dc.identifier.citationThe 50th Annual Meeting of the European Association for the Study of the Liver (International Liver Congress™ 2015), Vienna, Austria, 22-26 April 2015. In Journal of Hepatology, 2015, v. 62 suppl. 2, p. S194, abstract no. O009-
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/214867-
dc.descriptionOral Presentation - General viral hepatitis: no. O009-
dc.descriptionThis journal suppl. entitled: Abstracts of The International Liver Congress™ 2015 - 50 Annual meeting of the European Association for the Study of the Liver-
dc.description.abstractBACKGROUND AND AIMS: Patterns of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-negative, antibody to the hepatitis B core antigen (anti-HBc)-positive individuals undergoing hematopoietic stem cell transplantation (HSCT) have not been well described. METHODS: From September 2011 onwards, we recruited treatmentnaive HBsAg-negative, anti-HBc-positive patients with baseline undetectable serum HBVDNA (<10 IU/mL), undergoing either autologous or allogenic HSCT. For allogenic HSCT, only recipients whose donors were HBsAg-negative were recruited. Liver biochemistry, serum HBVDNA, HBsAg and antibody to HBsAg (anti-HBs) were prospectively monitoring every 4 weeks after HSCT up to 2 years. Following guidelines from the European Association for the Study of the Liver, entecavir was started when HBV reactivation, defined as detectable HBVDNA (≥10 IU/mL) was encountered. RESULTS: At the time of writing, among 328 patients undergoing HSCT, 89 (27.3%) were HBsAg-negative, anti-HBc-positive, of whom 67 (75.3%) fulfilled our inclusion criteria and were recruited. The median duration of follow-up was 52 (range 4–104) weeks. The 2-year cumulative HBV reactivation rate, calculated using the Kaplan–Meier method, was 36.8%. Thirteen patients developed reactivation after a median duration of 44 (range 8–100) weeks, of whom 11 patients (84.6%) remained HBsAg-negative at reactivation. Median HBVDNA level at reactivation was 24.8 (range 14.6–428) IU/mL. Patients with acute and/or chronic graft-versus-host-disease (GVHD) had a significantly higher 2-year cumulative rate of HBV reactivation than those without (acute GVHD: 78.8% versus 22.4%, p = 0.006; chronic GVHD: 83.8% versus 23.3%, p < 0.001). Other clinical parameters, including age, anti-HBs status, and donor serology had no association with HBV reactivation (all p > 0.05). Multivariate Cox regression analysis showed that chronic GVHD was the only factor independently associated with reactivation (p = 0.030, hazard ratio 3.9, 95% confidence interval 1.1–13.8). Entecavir treatment successfully controlled HBV reactivation in all cases. CONCLUSIONS: From this interim analysis, a substantial proportion of HBsAg-negative, anti-HBc-positive patients developed HBV reactivation after HSCT, with risk of reactivation significantly higher in patients with chronic GVHD. Periodic HBVDNA monitoring was an effective strategy in preventing HBV-related complications.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatology-
dc.subjectMedical sciences-
dc.subjectGastroenterology-
dc.titleA prospective study of hepatitis B reactivation in patients with prior HBV exposure undergoing hematopoietic stem cell transplantation: reactivation association with graft-versus-host disease-
dc.typeConference_Paper-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailChan, TSY: drtchan@hku.hk-
dc.identifier.emailHwang, YY: yyhwang@hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailLiu, KSH: drkliu@hku.hk-
dc.identifier.emailSingh, GHH: gillhsh@hku.hk-
dc.identifier.emailLam, YF: fyflam@hku.hk-
dc.identifier.emailFung, J: jfung@hkucc.hku.hk-
dc.identifier.emailLie, AKW: akwlie@hkucc.hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailKwong, YL: ylkwong@hkucc.hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authoritySingh, GHH=rp01914-
dc.identifier.authorityFung, J=rp00518-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityKwong, YL=rp00358-
dc.identifier.authorityYuen, MF=rp00479-
dc.identifier.doi10.1016/S0168-8278(15)30016-7-
dc.identifier.hkuros248017-
dc.identifier.volume62-
dc.identifier.issuesuppl. 2-
dc.identifier.spageS194, abstract no. O009-
dc.identifier.epageS194, abstract no. O009-
dc.publisher.placeNetherlands-

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