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Effectiveness of Prophylactic Anti‐HBV Therapy in Allogeneic Hematopoietic Stem Cell Transplantation with HBsAg Positive Donors
Author(s) -
Hui Cheekin,
Lie Albert,
Au Wingyan,
Ma Shingyan,
Leung YuHung,
Zhang Haiying,
Sun Jian,
Cheung Winnie W.W.,
Chim Chorsang,
Kwong Yoklam,
Liang Raymond,
Lau George K.K.
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.00887.x
Subject(s) - medicine , hbsag , lamivudine , hepatitis b virus , hepatitis b , hematopoietic stem cell transplantation , transplantation , gastroenterology , immunology , virus
Use of hepatitis B surface antigen (HBsAg) positive donors for allogeneic hematopoietic stem cell transplantation (HSCT) causes serious hepatitis B virus (HBV)‐related liver morbidity and mortality in the recipient. We compared the effectiveness of anti‐HBV therapy in 29 recipients who underwent HSCT using HBsAg positive marrow (group I) against a historical control group of 25 patients who received HBsAg positive marrow without pre‐HSCT prophylaxis (group II). Anti‐HBV therapy consisted of lamivudine for HBsAg‐positive donors and all recipients (n = 29) as well as HBV vaccination to all HBsAg‐negative recipients (n = 10) before HSCT. After transplantation, HBV‐related hepatitis was significantly higher in group II than group I recipients [12 of 25 recipients (48%) vs. 2 of 29 recipients (6.9%), p = 0.002] and in recipients whose donors had detectable serum HBV DNA by Digene Hybrid Capture II assay [8 of 14 recipients (57.1%) vs. 6 of 40 recipients (15.0%), p = 0.02]. Six recipients in group II and none in group I died of HBV‐related hepatic failure (24.0% vs. 0%, p = 0.01). By multivariate Cox analysis, anti‐HBV therapy effectively reduces post‐HSCT HBV‐related hepatitis (p = 0.01, adjusted hazards ratio 7.27, 95%CI 1.62–32.58). Our data support the use of prophylactic therapy in preventing HBV‐related hepatitis after allogeneic HSCT from HBsAg‐positive donor.