Hepatology International

, Volume 11, Issue 1, pp 87–95 | Cite as

HBV reactivation risk factors in patients with chronic HBV infection with low replicative state and resolved HBV infection undergoing hematopoietic stem cell transplantation in Korea

  • Chung Hwan Jun
  • Ban Suk Kim
  • Chan Young Oak
  • Du Hyeon Lee
  • Eunae Cho
  • Sung Bum Cho
  • Sung Kyu Choi
  • Chang Hwan Park
  • Young Eun Joo
  • Je-Jung Lee
  • Hyeoung-Joon Kim
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

To elucidate the rate and risk factors of HBV reactivation in patients with chronic HBV infection with low replicative state and resolved HBV infection undergoing allogenic/autologous hematopoietic stem-cell transplantation (HSCT) in Korea.

Methods

The medical charts of 506 patients who underwent allogenic/autologous HSCT from January 2008 to December 2013 were analyzed retrospectively. We examined the reactivation rate and variables related to the risk of HBV reactivation, with a median follow-up period of 41.8 (1–245) months. Univariate analysis was used to identify any factors associated with HBV reactivation. Factors that were significant in the univariate analysis were entered into a stepwise multivariate analysis to find the most significant risk factors associated with HBV reactivation.

Results

The reactivation rate of HBV in patients who underwent HSCT was 4.2 % (21/506). In subgroup analysis, the HBV reactivation rate (14.3 %) was the highest among HBsAg(+) patients (5/35). The reactivation rate of HBV in patients with resolved HBV infection [HBsAg(−)/HBcAb(+) with or without anti-HBs antibody] was 5.9 % (10/171). In univariate analysis for risk factors of HBV reactivation in patients who underwent HSCT, initial detectable HBV DNA (p = 0.004), age (≥60 years) (p = 0.012), recipient hepatitis B surface antigen-positive (HbsAg)(+) before HSCT (p = 0.004), recipient hepatitis B surface antibody-negative (HBsAb)(−) before HSCT (p = 0.005), recipient hepatitis B core antibody-positive (HbcAb)(+) before HSCT (p = 0.013), and donor HBsAg(+) (p < 0.001) were associated with reactivation of HBV. In multivariate analysis, significant risk factors of HBV reactivation in patients who underwent HSCT were old age (≥60 years) (p = 0.032) and donor HBsAg(+) (p = 0.026).

Conclusion

Old age (≥60 years) and donor HBsAg(+) were risk factors for HBV reactivation in HSCT patients. Preemptive antiviral treatment should be considered in these patients.

Keywords

Hematopoietic stem-cell transplantation Hepatitis B virus Reactivation Risk factors 
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Notes

Compliance with ethical standards

Conflict of interest

Chung Hwan Jun, Ban Suk Kim, Chan Young Oak, Du Hyeon Lee, Eunae Cho, Sung Bum Cho, Sung Kyu Choi, Chang Hwan Park, Young Eun Joo, Je-Jung Lee, and Hyeoung-Joon Kim have no conflict of interest to declare.

Funding

None.

Ethical approval

This study was approved by the Institutional Review Board of Chonnam National University Hospital.

Informed consent

Written informed consent was obtained from all of the patients regarding the nature and the purpose of the treatment.

Statement of human rights

The studies have been approved by the appropriate institutional and/or national research ethics committee and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Copyright information

© Asian Pacific Association for the Study of the Liver 2016

Authors and Affiliations

  • Chung Hwan Jun
    • 1
  • Ban Suk Kim
    • 1
  • Chan Young Oak
    • 1
  • Du Hyeon Lee
    • 1
  • Eunae Cho
    • 1
  • Sung Bum Cho
    • 1
  • Sung Kyu Choi
    • 1
  • Chang Hwan Park
    • 1
  • Young Eun Joo
    • 1
  • Je-Jung Lee
    • 2
  • Hyeoung-Joon Kim
    • 2
  1. 1.Division of Gastroenterology, Department of Internal MedicineChonnam National University Medical SchoolGwangjuKorea
  2. 2.Division of Hematology, Department of Internal MedicineChonnam National University Medical SchoolGwangjuKorea

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