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The Importance of Antiviral Prophylaxis in Anti Hbc Positive Patients with Autologous Haematopoietic Stem Cell Transplantation
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Original Article
VOLUME: 53 ISSUE: 3
P: 523-531
2020

The Importance of Antiviral Prophylaxis in Anti Hbc Positive Patients with Autologous Haematopoietic Stem Cell Transplantation

Acta Haematol Oncol Turc 2020;53(3):523-531
DOI: 10.5505/aot.2020.81894
Sabahat Çeken 1
Merih Kızıl Çakar 2
Gülşen İskender 1
Duygu Mert 1
Habip Gedik 3
Göknur Yapar Toros 1
Mehmet Sinan Dal 2
Fevzi Altuntas 2
Mustafa Ertek 1
1. Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Ankara; Turkey
2. Dr. AbdurrahmanYurtaslan Ankara Oncology Training and Research Hospital, Department of Hematology, Ankara, Turkey
3. Bakırkoy Sadi Konuk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
4.
No information available.
No information available
Received Date: 2020-09-05T20:35:52
Accepted Date: 2020-12-30T17:45:53
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Abstract

INTRODUCTION

The aim of the study is to investigate the factors affecting HBV reactivation in patients with autologous hematopoietic stem cell transplantation (HSCT) and to evaluate the necessity of hepatitis prophylaxis in HBs Ag negative/AntiHbc IgG positive patients

METHODS

The study is a retrospective observational cohort study conducted in a 500-bed teaching hospital. Patients who were planned to get immunosuppressive therapy for malignancy were screened for HBV by Hbs Ag, Anti HBs, and Anti Hbc IgG levels. The study population was consisted of patients, who had autologous HSCT in our hospital between May 2012 and December 2018, and were positive for Anti Hbc IgG.

RESULTS

HBs Ag, Anti Hbs, and Anti Hbc IgG test results of 328 patients who underwent HSCT were examined. The median age was 59 years (Range: 23-66 years) and 63 (65.6%) of them were male. HBV-DNA was detected in low values in five (5.9%) of HBs Ag negative/Anti Hbc IgG positive patients (occult hepatitis). Nucleot(s)ide analogue (NA) prophylaxis was administered to those patients. Totally 52 (61.9%) of the Hbs Ag negative patients received NA prophylaxis. HBV reactivation occurred in four (12.5 %) of 32 patients who did not receive any antiviral prophylaxis, in a median of 9 months (6-13 months) after transplantation

DISCUSSION AND CONCLUSION

Antiviral prophylaxis should be administered to autologous HSCT patients, who are HBs Ag negative/anti-HBc IgG positive, taking into consideration the risk of HBV reactivation. Lamivudine (LAM) is as effective as the potent NAs in the prophylaxis for those patients, and 12 months is enough for prophylaxis.