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Article: High hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation
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TitleHigh hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation
 
AuthorsLau, GKK1
Leung, YH1
Fong, DYT1
Au, WY1
Kwong, YL1
Lie, A1
Hou, JL1
Wen, YM1
Nanj, A1
Liang, R1
 
Issue Date2002
 
PublisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/
 
CitationBlood, 2002, v. 99 n. 7, p. 2324-2330 [How to Cite?]
DOI: http://dx.doi.org/10.1182/blood.V99.7.2324
 
AbstractThe risk factors for hepatitis due to hepatitis B virus (HBV) reactivation in patients positive for hepatitis B surface antigen (HBsAg) treated with autologous hematopoietic cell transplantation (HCT) are unknown. We evaluated 137 consecutive patients (23 positive for HBsAg, 37 positive for hepatitis B surface antibody, and 77 negative for HBV) who underwent HCT. Serial serum ALT were measured before transplant and after transplant at 1 to 4 weekly intervals for the first year and then at 2 to 12 weekly intervals thereafter. Before HCT, basic core promoter (T 1762/A 1764) and precore (A 1896) HBV variants were determined in HBsAg-positive and HBV DNA-positive (by polymerase chain reaction assay) patients by direct sequencing and serum HBV DNA quantitation using the Digene Hybrid Capture II assay. Cox proportional hazards analysis was used to assess the association between pretransplantation HBV virologic and host factors and occurrence of hepatitis due to HBV reactivation. After HCT, hepatitis due to HBV reactivation was more common in HBsAg-positive patients than in HBsAg-negative patients (hazard ratio, 33.3; 95% confidence interval [Cl], 7.35-142.86; P < .0001). HBsAgpositive patients with detectable serum HBV DNA before HCT (on Digene assay) had a significantly higher risk of hepatitis due to HBV reactivation than HBsAgpositive patients with no detectable serum HBV DNA (adjusted hazard ratio, 9.35; 95% CI, 1.65-52.6; P= .012). Thus, we found that hepatitis due to HBV reactivation is common in HBsAg-positive patients undergoing autologous HCT. A high HBV DNA level (>10 5 copies/mL) was the most important risk factor for HBV reactivation, and its lowering by administration of nucleoside analogues before transplantation should be considered. © 2002 by The American Society of Hematology.
 
ISSN0006-4971
2013 Impact Factor: 9.775
 
DOIhttp://dx.doi.org/10.1182/blood.V99.7.2324
 
ISI Accession Number IDWOS:000174559300009
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLau, GKK
 
dc.contributor.authorLeung, YH
 
dc.contributor.authorFong, DYT
 
dc.contributor.authorAu, WY
 
dc.contributor.authorKwong, YL
 
dc.contributor.authorLie, A
 
dc.contributor.authorHou, JL
 
dc.contributor.authorWen, YM
 
dc.contributor.authorNanj, A
 
dc.contributor.authorLiang, R
 
dc.date.accessioned2010-09-06T09:31:51Z
 
dc.date.available2010-09-06T09:31:51Z
 
dc.date.issued2002
 
dc.description.abstractThe risk factors for hepatitis due to hepatitis B virus (HBV) reactivation in patients positive for hepatitis B surface antigen (HBsAg) treated with autologous hematopoietic cell transplantation (HCT) are unknown. We evaluated 137 consecutive patients (23 positive for HBsAg, 37 positive for hepatitis B surface antibody, and 77 negative for HBV) who underwent HCT. Serial serum ALT were measured before transplant and after transplant at 1 to 4 weekly intervals for the first year and then at 2 to 12 weekly intervals thereafter. Before HCT, basic core promoter (T 1762/A 1764) and precore (A 1896) HBV variants were determined in HBsAg-positive and HBV DNA-positive (by polymerase chain reaction assay) patients by direct sequencing and serum HBV DNA quantitation using the Digene Hybrid Capture II assay. Cox proportional hazards analysis was used to assess the association between pretransplantation HBV virologic and host factors and occurrence of hepatitis due to HBV reactivation. After HCT, hepatitis due to HBV reactivation was more common in HBsAg-positive patients than in HBsAg-negative patients (hazard ratio, 33.3; 95% confidence interval [Cl], 7.35-142.86; P < .0001). HBsAgpositive patients with detectable serum HBV DNA before HCT (on Digene assay) had a significantly higher risk of hepatitis due to HBV reactivation than HBsAgpositive patients with no detectable serum HBV DNA (adjusted hazard ratio, 9.35; 95% CI, 1.65-52.6; P= .012). Thus, we found that hepatitis due to HBV reactivation is common in HBsAg-positive patients undergoing autologous HCT. A high HBV DNA level (>10 5 copies/mL) was the most important risk factor for HBV reactivation, and its lowering by administration of nucleoside analogues before transplantation should be considered. © 2002 by The American Society of Hematology.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationBlood, 2002, v. 99 n. 7, p. 2324-2330 [How to Cite?]
DOI: http://dx.doi.org/10.1182/blood.V99.7.2324
 
dc.identifier.doihttp://dx.doi.org/10.1182/blood.V99.7.2324
 
dc.identifier.epage2330
 
dc.identifier.hkuros65523
 
dc.identifier.isiWOS:000174559300009
 
dc.identifier.issn0006-4971
2013 Impact Factor: 9.775
 
dc.identifier.issue7
 
dc.identifier.openurl
 
dc.identifier.pmid11895763
 
dc.identifier.scopuseid_2-s2.0-0036530048
 
dc.identifier.spage2324
 
dc.identifier.urihttp://hdl.handle.net/10722/87594
 
dc.identifier.volume99
 
dc.languageeng
 
dc.publisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofBlood
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshChild
 
dc.subject.meshChild, Preschool
 
dc.subject.meshDNA Primers
 
dc.subject.meshDNA, Viral - blood
 
dc.subject.meshFemale
 
dc.subject.meshHematopoietic Stem Cell Transplantation
 
dc.subject.meshHepatitis B - mortality - therapy - virology
 
dc.subject.meshHepatitis B Surface Antigens - blood
 
dc.subject.meshHepatitis B virus - growth & development
 
dc.subject.meshHumans
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshPolymerase Chain Reaction
 
dc.subject.meshProportional Hazards Models
 
dc.subject.meshRetrospective Studies
 
dc.subject.meshSurvival Rate
 
dc.subject.meshViral Load
 
dc.subject.meshVirus Activation
 
dc.titleHigh hepatitis B virus (HBV) DNA viral load as the most important risk factor for HBV reactivation in patients positive for HBV surface antigen undergoing autologous hematopoietic cell transplantation
 
dc.typeArticle
 
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<contributor.author>Au, WY</contributor.author>
<contributor.author>Kwong, YL</contributor.author>
<contributor.author>Lie, A</contributor.author>
<contributor.author>Hou, JL</contributor.author>
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<description.abstract>The risk factors for hepatitis due to hepatitis B virus (HBV) reactivation in patients positive for hepatitis B surface antigen (HBsAg) treated with autologous hematopoietic cell transplantation (HCT) are unknown. We evaluated 137 consecutive patients (23 positive for HBsAg, 37 positive for hepatitis B surface antibody, and 77 negative for HBV) who underwent HCT. Serial serum ALT were measured before transplant and after transplant at 1 to 4 weekly intervals for the first year and then at 2 to 12 weekly intervals thereafter. Before HCT, basic core promoter (T 1762/A 1764) and precore (A 1896) HBV variants were determined in HBsAg-positive and HBV DNA-positive (by polymerase chain reaction assay) patients by direct sequencing and serum HBV DNA quantitation using the Digene Hybrid Capture II assay. Cox proportional hazards analysis was used to assess the association between pretransplantation HBV virologic and host factors and occurrence of hepatitis due to HBV reactivation. After HCT, hepatitis due to HBV reactivation was more common in HBsAg-positive patients than in HBsAg-negative patients (hazard ratio, 33.3; 95% confidence interval [Cl], 7.35-142.86; P &lt; .0001). HBsAgpositive patients with detectable serum HBV DNA before HCT (on Digene assay) had a significantly higher risk of hepatitis due to HBV reactivation than HBsAgpositive patients with no detectable serum HBV DNA (adjusted hazard ratio, 9.35; 95% CI, 1.65-52.6; P= .012). Thus, we found that hepatitis due to HBV reactivation is common in HBsAg-positive patients undergoing autologous HCT. A high HBV DNA level (&gt;10 5 copies/mL) was the most important risk factor for HBV reactivation, and its lowering by administration of nucleoside analogues before transplantation should be considered. &#169; 2002 by The American Society of Hematology.</description.abstract>
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<subject.mesh>Adolescent</subject.mesh>
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<subject.mesh>Survival Rate</subject.mesh>
<subject.mesh>Viral Load</subject.mesh>
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Author Affiliations
  1. The University of Hong Kong