Effectiveness of prophylactic antiviral therapy in reducing HBV reactivation for HBsAg-positive recipients following allogeneic hematopoietic stem cell transplantation: a multi-institutional experience from an HBV endemic area

• Published in: Annals of hematology 2022-03, Vol.101 (3), p.631-641
• Main Authors: Wu, Yibo, Chen, Yi, Zhu, Panpan, Ye, Baodong, Lu, Ying, Shi, Jimin, Tan, Yamin, Zhao, Yanmin, Yu, Jian, Lai, Xiaoyu, Lan, Jianping, Si, Ting, Ni, Lihong, Huang, He, Luo, Yi
• Format: Article
• Language: English
• Subjects: Adult; Antigens; Antiviral Agents - therapeutic use; Antiviral drugs; Bone marrow; Cytomegalovirus; Disease prevention; Female; Graft versus host disease; Guanine - analogs & derivatives; Guanine - therapeutic use; Hematology; Hematopoietic Stem Cell Transplantation - adverse effects; Hepatitis B; Hepatitis B - blood; Hepatitis B - etiology; Hepatitis B - prevention & control; Hepatitis B - virology; Hepatitis B Surface Antigens - blood; Hepatitis B virus - drug effects; Hepatitis B virus - physiology; Hospitals; Humans; Laboratories; Lamivudine - therapeutic use; Leukemia; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Retrospective Studies; Serology; Stem cell transplantation; Transplantation, Homologous - adverse effects; Virus Activation - drug effects; Young Adult
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-021-04730-6

Hepatitis B virus reactivation (HBVr) is not uncommon in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Hepatitis B surface antigen (HBsAg)-positive patients receiving allo-HSCT have a very high risk of HBVr. However, the validity of prophylactic antiviral treatment in HBsAg-positive allo-HSCT recipients has not been well studied. We aimed to add experience in dealing with HBsAg-positive patients following allo-HSCT. We conducted a cohort study that included 11 years of data of HBsAg-positive allo-HSCT patients in multiple centers. The cumulative incidence of HBVr with antiviral prophylaxis at 60 months following transplantation was 8.9%. Both lamivudine (LAM) and entecavir (ETV) effectively reduced the incidence of HBVr. Patients with absent-mild cGVHD had a lower HBVr rate than that of patients with moderate-severe cGVHD (HR = 0.201, P  = 0.020). The incidence of HBsAg seroclearance at 60 months following transplantation was 34.3%. Recipients accepting from anti-HBs–negative donors were associated with a lower HBsAg seroclearance rate than that of those accepting from anti-HBs–positive donors (HR=0.255, P