The frequency of hepatitis B virus reactivation in patients with bone marrow transplantation

Ayhan Balkan; Melya Pelin Kirik; Ilknur Gundes; Handan Haydaroglu Sahin; Selin Budeyri; Yasemin Balkan

doi:10.5152/EurJTher.2017.19

Authors

Ayhan Balkan Department of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey
Melya Pelin Kirik Gaziantep University
Ilknur Gundes Gaziantep University
Handan Haydaroglu Sahin Gaziantep University
Selin Budeyri Gaziantep University
Yasemin Balkan Gaziantep University

DOI:

https://doi.org/10.5152/EurJTher.2017.19

Keywords:

Bone marrow transplantation, hepatitis B reactivation, immunosuppressed host

Abstract

Objective: All patients with serologic evidence of a previous hepatitis B virus (HBV) infection have the risk of reactivation. The present study aimed to determine the prevalence of HBV infection/reactivation and to identify possible factors causing reactivation in patients who underwent bone marrow transplantation.

Methods: In total, 442 patients who underwent allogeneic and autologous peripheral stem cell transplantation between April 2011 and December 2016 were included. Hepatitis B virus serologies, chemotherapy regimens received, and antiviral treatments were retrospectively evaluated.

Results: The number of HBsAg-positive patients was 36 (8.1%) and that of HBsAg-negative/anti-HBc-positive patients was 74 (16.7%); antiviral treatment was given to all patients. There was no HBV reactivation at the median follow-up of 21 months.

Conclusion: All patients receiving immunosuppressive therapy should be screened for HBV infection and evaluated for the prophylactic treatment of HBV. Thus, the risk of HBV reactivation is minimized, and a preventive approach should always be considered for patients.

Metrics

Metrics Loading ...

References

Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva: World Health Organization; 2015.

Di Bisceglie AM, Lok AS, Martin P, Terrault N, Perrillo RP, Hoofnagle JH. Recent US Food and Drug Administration warnings on hepatitis B reactivation with immune-suppressing and anticancer drugs: just the tip of the iceberg? Hepatology 2015; 61: 703-11.

Tosun S. Viral hepatitlerin ülkemizdeki değişen epidemiyolojisi. Ankem Derg 2013; 27: 128-34.

Tosun S. Türkiye’de viral hepatit B epidemiyolojisi: yayınların metaanalizi. In: Tabak F, Tosun S, editors. Viral Hepatit 2013. Ankara: Viral Hepatitle Savaşım Derneği, 2013: 27-80.

Perrillo RP, Gish R, Falck-Ytter YT. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology 2015; 148: 221-44.

Loomba R, Rowley A, Wesley R, Liang TJ, Hoofnagle JH, Pucino F, Csako G. Systematic review: the effect of preventive lamivudine on hepatitis B reactivation during chemotherapy. Ann Intern Med 2008; 148: 519-28.

Perrillo RP, Martin P, Lok AS. Preventing hepatitis B reactivation due to immunosuppressive drug treatments. JAMA 2015; 313: 1617-8.

Paul S, Saxena A, Terrin N, Viveiros K, Balk EM, Wong JB. Hepatitis B Virus Reactivation and Prophylaxis During Solid Tumor Chemotherapy: A Systematic Review and Meta-analysis. Ann Intern Med 2016; 164: 30-40.

Hoofnagle JH. Reactivation of hepatitis B. Hepatology 2009; 49(5 Suppl): S156-65.

Lok AS, Liang RH, Chiu EK, Wong KL, Chan TK, Todd D. Reactivation of hepatitis B virus replication in patients receiving cytotoxic therapy. Report of a prospective study. Gastroenterology 1991; 100: 182-8.

European Association For The Study Of The Liver. EASL clinical practice guidelines: Management of chronic hepatitis B virus infection. J Hepatol 2012; 57: 167-85.

Liaw YF, Kao JH, Piratvisuth T, Chan HL, Chien RN, Liu CJ, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int 2012; 6: 531-61.

Weinbaum CM, Williams I, Mast EE, Wang SA, Finelli L, Wasley A, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep 2008; 57: 1-20.

Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology 2009; 50: 661-2.

Lee R, Vu K, Bell CM, Hicks LK. Screening for hepatitis B surface antigen before chemotherapy: current practice and opportunities for improvement. Curr Oncol 2010; 17: 32-8.

Day FL, Link E, Thursky K, Rischin D. Current hepatitis B screening practices and clinical experience of reactivation in patients undergoing chemotherapy for solid tumors: a nationwide survey of medical oncologists. J Oncol Pract 2011; 7: 141-7.

Alvarez-Suarez B, de-la-Revilla-Negro J, Ruiz-Antorán B, Calleja-Panero JL. Hepatitis B reactivation and current clinical impact. Rev Esp Enferm Dig 2010; 102: 542-52.

Jang JW, Choi JY, Bae SH, Yoon SK, Chang UI, Kim CW, et al. A randomized controlled study of preemptive lamivudine in patients receiving trans arterial chemo-lipiodolization. Hepatology 2006; 43: 233-40.

Mozessohn L, Chan KK, Feld JJ, Hicks LK. Hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients receiving rituximab for lymphoma: a meta-analysis. J Viral Hepat 2015; 22: 842-9.

Yeo W, Chan TC, Leung NW, Lam WY, Mo FK, Chu MT, et al. Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab. J Clin Oncol 2009; 27: 605-11.

Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology 2015; 148: 215-9.

Bréchot C, Degos F, Lugassy C, Thiers V, Zafrani S, Franco D, et al. Hepatitis B virus DNA in patients with chronic liver disease and negative tests for hepatitis B surface antigen. N Engl J Med 1985; 312: 270-76.

Chemin I, Jeantet D, Kay A, Trépo C. Role of silent hepatitis B virus in chronic hepatitis B surface antigen(-) liver disease. Antiviral Res 2001; 52: 117-23.

Locasciulli A, Bruno B, Alessandrino EP, Meloni G, Arcese W, Ban¬dini G, et al. Hepatitis reactivation and liver failure in haemopoietic stem cell transplants for hepatitis B virus (HBV)/hepatitis C virus (HCV) positive recipients: a retrospective study by the Italian group for blood and marrow transplantation. Bone Marrow Transplant 2003;

: 295-300.

Senecal D, Pichon E, Dubois F, Delain M, Linassier C, Colombat P. Acute hepatitis B after autologous stem cell transplantation in a man previously infected by hepatitis B virus. Bone Marrow Trans¬plant 1999; 24: 1243-4.

Dhédin N, Douvin C, Kuentz M, Saint Marc MF, Reman O, Rieux C, et al. Reverse seroconversion of hepatitis B after allogeneic bone marrow transplantation: a retrospective study of 37 patients with pretransplant anti-HBs and Anti-HBc. Transplantation 1998; 66: 616-9.

WangY, Luo XM, Yang D, Zhang J, Zhuo HY, Zhang J, Jiang Y. Testing for hepatitis B infection in prospective chemotherapy patients: a retrospective study. World J Gastroenterol 2013; 19: 923-30.

Mikulska M, Nicolini L, Signori A, Rivoli G, Del Bono V, Raiola AM, et al. Hepatitis B reactivation in HBsAg-negative/HBcAb-positive allogeneic haematopoietic stem cell transplant recipients: risk factors and outcome. Clin Microbiol Infect 2014; 20: O694-701.

Iloeje UH, Yang HI, Su J, Jen CL, You SL, Chen CJ; Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-In HBV (the REVEAL-HBV) Study Group. Predicting cirrhosis risk based on the level of circulating hepatitis B viral load. Gastroenterology 2006; 130: 678-86.

European Association For The Study Of The Liver. EASL Clinical Practice Guidelines: management of chronic hepatitis B. J Hepatol 2009; 50: 227-42.

Lalazar G, Rund D, Shouval D. Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies. Br J Haematol 2007; 136: 699-712.