ISSN: 2149-2247 | E-ISSN: 2149-2549
Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation [Erciyes Med J]
Erciyes Med J. 2021; 43(1): 31-36 | DOI: 10.14744/etd.2020.36786

Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation

Zeynep Türe1, Gamze Kalin Unuvar1, Hüseyin Nadir Kahveci1, Muzaffer Keklik2, Ayşegul Ulu Kilic1
1Department of Infectious Diseases, Erciyes University Faculty of Medicine, Kayseri, Turkey
2Department of Hematology, Erciyes University Faculty of Medicine, Kayseri, Turkey

Objective: The reactivation rate of dormant hepatitis B virus (HBV) in the liver is between 4.1% and 41.5% in immune-compromised patients. The disappearance of hepatitis B surface antibody (anti-HBs) can be an alarm for hepatitis B reactivation. In this study, the changes in serological status, reactivation rates, and antiviral prophylaxis rates were evaluated.
Materials and Methods: A retrospective study was conducted involving patients who were followed up at Erciyes University HSCT Center between January 2018 and July 2019. The demographic data, type of hematological disease, pre- and post-transplant status of HBV, presence of antiviral prophylaxis, and frequency of hepatitis B flare were evaluated.
Results: One hundred and seven patients were included in this study. The median follow-up duration was 18 months. New chemotherapy protocols were initiated in 36 patients due to progression and in 23 patients with a diagnosis of graft-versus-host disease. Anti-HBs levels decreased in 60% of the patients, and anti-HBs levels decreased to below the protective level in 13% of the patients. Among the 107 patients, 38 had resolved hepatitis B infection before transplantation, and 20 and four of 18 patients (22%) who did not receive antiviral prophylaxis developed HBV seroconversion and hepatitis B flare. The median levels of anti-HBs titers after transplantation were 167 IU/L and 15 IU/L in groups that received and did not receive antiviral prophylaxis, respectively (p=0.028).
Conclusion: Antiviral prophylaxis should be administered in patients positive for hepatitis B core antibody before hematopoietic stem-cell transplantation. Measuring HBV serological parameters at regular intervals is essential in the high-risk group.

Keywords: Hepatitis B, hematopoietic setem cell transplantation, reverse seroconversion, HBV reactivation

Zeynep Türe, Gamze Kalin Unuvar, Hüseyin Nadir Kahveci, Muzaffer Keklik, Ayşegul Ulu Kilic. Overlooked Prophylaxis of Hepatitis B in Patients Undergoing Hematopoietic Stem Cell Transplantation. Erciyes Med J. 2021; 43(1): 31-36

Corresponding Author: Zeynep Türe, Türkiye
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