TY - JOUR
T1 - Hepatitis B reactivation in HBsAg-negative/HBcAb-positive allogeneic haematopoietic stem cell transplant recipients
T2 - Risk factors and outcome
AU - Mikulska, M.
AU - Nicolini, L.
AU - Signori, A.
AU - Rivoli, G.
AU - Del Bono, V.
AU - Raiola, A. M.
AU - Di Grazia, C.
AU - Dominietto, A.
AU - Varaldo, R.
AU - Ghiso, A.
AU - Bacigalupo, A.
AU - Viscoli, C.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - HBsAg-negative/HBcAb-positive haematopoietic stem cell transplant (HSCT) recipients are at high risk of hepatitis B virus (HBV) reactivation. Allogeneic HSCT recipients from years 2000 to 2010 were evaluated in order to study the impact of being HBsAg-negative/HBcAb-positive in this population. Overall, 137 of 764 patients (18%) were HBsAg-negative/HBcAb-positive before HSCT. Overall survival, non-relapse mortality (NRM), acute and chronic graft-vs.-host disease were similar in HBcAb-positive and HBcAb-negative patients. Reactivation occurred in 14 patients (10%) within a median of 19 months after HSCT (range 9-77). Cause-specific hazard for reactivation was decreased in the case of an HBV-immune/exposed donor (HRadjusted = 0.12; 95% CI, 0.02-0.96; p 0.045) and increased in patients who received rituximab treatment (HRadjusted = 2.91; 95%CI, 0.77-10.97; p 0.11). Competing risk analyses documented a protective role of an HBV-immune/exposed donor (p 0.041) and an increased probability associated with the length of treatment with cyclosporine (p
AB - HBsAg-negative/HBcAb-positive haematopoietic stem cell transplant (HSCT) recipients are at high risk of hepatitis B virus (HBV) reactivation. Allogeneic HSCT recipients from years 2000 to 2010 were evaluated in order to study the impact of being HBsAg-negative/HBcAb-positive in this population. Overall, 137 of 764 patients (18%) were HBsAg-negative/HBcAb-positive before HSCT. Overall survival, non-relapse mortality (NRM), acute and chronic graft-vs.-host disease were similar in HBcAb-positive and HBcAb-negative patients. Reactivation occurred in 14 patients (10%) within a median of 19 months after HSCT (range 9-77). Cause-specific hazard for reactivation was decreased in the case of an HBV-immune/exposed donor (HRadjusted = 0.12; 95% CI, 0.02-0.96; p 0.045) and increased in patients who received rituximab treatment (HRadjusted = 2.91; 95%CI, 0.77-10.97; p 0.11). Competing risk analyses documented a protective role of an HBV-immune/exposed donor (p 0.041) and an increased probability associated with the length of treatment with cyclosporine (p
KW - Bone marrow transplant
KW - Chronic graft-vs.-host disease
KW - Cyclosporin
KW - Occult HBV
KW - Resolved HBV hepatitis
KW - Reverse seroconversion
KW - Rituximab
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UR - http://www.scopus.com/inward/citedby.url?scp=84913612874&partnerID=8YFLogxK
U2 - 10.1111/1469-0691.12611
DO - 10.1111/1469-0691.12611
M3 - Article
C2 - 24575948
AN - SCOPUS:84913612874
VL - 20
SP - O694-O701
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
SN - 1198-743X
IS - 10
ER -