Hepatitis B virus (HBV) reverse seroconversion (RS) can be prevented even in non-responders to hepatitis B vaccine after allogeneic stem cell transplantation: long-term analysis of intervention in RS with vaccine for patients with previous HBV infection

Transpl Infect Dis. 2014 Oct;16(5):797-801. doi: 10.1111/tid.12283. Epub 2014 Aug 25.

Abstract

Background: Reactivation of hepatitis B virus (HBV) infection, reverse seroconversion (RS), is a serious complication after allogeneic stem cell transplantation (alloHSCT). We previously conducted a post-transplant hepatitis B vaccine intervention trial and demonstrated the vaccine efficacy in preventing HBV-RS. This report is an update of the hepatitis B vaccine study.

Methods: In this trial, 21 patients were enrolled and received a standard 3-dose regimen of hepatitis B vaccine after discontinuation of immunosuppressants, whereas 25 transplant recipients with previous HBV infection did not receive the vaccine and served as controls.

Results: None of the 21 patients in the vaccine group developed HBV-RS and 12 controls developed HBV-RS in median follow-up periods of 60 months (range 13-245). HBV vaccine resulted in a positive value of hepatitis B surface antibody (HBsAb) titer in 9 patients, while HBsAb remained negative in 12 patients. Presence of a high titer of HBsAb before vaccination was associated with conversion into HBsAb positivity after vaccination.

Conclusion: These results demonstrated the long-term effects of HBV vaccine for preventing HBV-RS after alloHSCT. Of note, no HBV-RS occurred, even in patients who did not achieve conversion into HBsAb positivity after vaccination.

Keywords: HBV; reverse seroconversion; stem cell transplantation; vaccine.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Hepatitis B / immunology*
  • Hepatitis B / prevention & control
  • Hepatitis B Antibodies / blood*
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B Vaccines*
  • Hepatitis B virus / immunology*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Care
  • Retrospective Studies
  • Stem Cell Transplantation*
  • Time Factors
  • Virus Activation / drug effects*
  • Young Adult

Substances

  • Hepatitis B Antibodies
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines