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. 2018 Oct;50(4):1121-1129.
doi: 10.4143/crt.2017.329. Epub 2017 Dec 4.

HBsAg-Negative, Anti-HBc-Negative Patients Still Have a Risk of Hepatitis B Virus-Related Hepatitis after Autologous Stem Cell Transplantation for Multiple Myeloma or Malignant Lymphoma

Hyunsung Park  1 , Do Young Kim  2 , Soo-Jeong Kim  1 , Haerim Chung  1 , Hyunsoo Cho  1 , Ji Eun Jang  1 , June-Won Cheong  1 , Yoo Hong Min  1 , Jae-Woo Song  3 , Jin Seok Kim  1
Affiliations

HBsAg-Negative, Anti-HBc-Negative Patients Still Have a Risk of Hepatitis B Virus-Related Hepatitis after Autologous Stem Cell Transplantation for Multiple Myeloma or Malignant Lymphoma

Hyunsung Park et al. Cancer Res Treat. 2018 Oct.

Abstract

Purpose: Although hepatitis B surface antigen (HBsAg)-negative, hepatitis B core antibody (anti-HBc)-negative patients are not considered to be at risk for hepatitis B virus (HBV)-related hepatitis, the actual risk remains to be elucidated. This study aimed to evaluate the risk of HBV-related hepatitis in HBsAg-negative, anti-HBc-negative patients receiving autologous stem cell transplantation (ASCT) for multiple myeloma (MM) or malignant lymphoma.

Materials and methods: We retrospectively reviewed data from 271 HBsAg-negative patients (161 anti-HBc-negative and 110 anti-HBc-positive at the time of ASCT) who received ASCT for MM or lymphoma. The risk of HBV-related hepatitis was analyzed according to the presence of anti-HBc. HBV serology results at the time of ASCT were compared with those at the time of diagnosis of MM or lymphoma.

Results: Three patients (two anti-HBc-negative MMs and one anti-HBc-positive MM) developed HBV-related hepatitis after ASCT. The rate of HBV-related hepatitis did not differ among patients with or without anti-HBc status (p=0.843). HBV-related hepatitis more frequently occurred in MM patients than in lymphoma patients (p=0.041). Overall, 9.1% of patients (16.7% with MM and 5.4% with lymphoma) who were HBsAg-negative and anti-HBc-positive at the time of diagnosis had lost anti-HBc positivity during chemotherapy prior to ASCT.

Conclusion: Our data suggest that HBsAg-negative, anti-HBc-negative patients at the time of ASCT for MM or lymphoma still might be at a risk for HBV-related hepatitis.

Keywords: HBV-related hepatitis; Hepatitis B core antibody; Lymphoma; Multiple myeloma; Stem cell transplantation.

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Conflict of interest statement

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1.
Fig. 1.
The incidence of hepatitis and hepatitis B surface antigen (HBsAg) reversion in 271 HBsAg-negative patients within and more than 1 year after autologous stem cell transplantation without hepatitis B virus (HBV) prophylaxis. Anti-HBc, hepatitis B core antibody; Anti-HBs, hepatitis B surface antibody; ASCT, autologous stem cell transplantation.
Fig. 2.
Fig. 2.
Changes in hepatitis B core antibody (anti-HBc) status (A) and hepatitis B surface antibody (anti-HBs) status (B) in hepatitis B surface antigen (HBsAg)–negative patients from diagnosis to transplantation. ASCT, autologous stem cell transplantation.
See this image and copyright information in PMC

References

    1. Pei SN, Chen CH. Risk and prophylaxis strategy of hepatitis B virus reactivation in patients with lymphoma undergoing chemotherapy with or without rituximab. Leuk Lymphoma. 2015;56:1611–8. - PubMed
    1. Hwang JP, Lok AS. Management of patients with hepatitis B who require immunosuppressive therapy. Nat Rev Gastroenterol Hepatol. 2014;11:209–19. - PMC - PubMed
    1. Lok AS, McMahon BJ. Chronic hepatitis B: update 2009. Hepatology. 2009;50:661–2. - PubMed
    1. Gu HR, Shin DY, Choi HS, Moon CH, Park SC, Kang HJ. HBV reactivation in a HBsAg-negative patient with multiple myeloma treated with prednisolone maintenance therapy after autologous HSCT. Blood Res. 2015;50:51–3. - PMC - PubMed
    1. Yoshida T, Kusumoto S, Inagaki A, Mori F, Ito A, Ri M, et al. Reactivation of hepatitis B virus in HBsAg-negative patients with multiple myeloma: two case reports. Int J Hematol. 2010;91:844–9. - PubMed

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