1
|
Yin Z, Wen T, Fu C, Li J, Fang Q, Gong X, You J, Wang S, Zheng C. Comparison of the effectiveness four years after Homo/Hetero prime-boost with 10 μg HP and 20 μg CHO recombinant hepatitis B vaccine at 1 and 6 months in maternal HBsAg-negative children. Front Immunol 2024; 15:1308238. [PMID: 38660313 PMCID: PMC11039823 DOI: 10.3389/fimmu.2024.1308238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/29/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Limited data were available on the effectivenessfour years after Homo or Hetero prime-boost with 10 μg Hansenulapolymorpha recombinant hepatitis B vaccine (HepB-HP) and 20 μgChinese hamster ovary cell HepB (HepB-CHO). Methods A crosssectional study was performed in maternalhepatitis B surface antigen (HBsAg)-negative children whoreceived one dose of 10 μg HepB-HP at birth, Homo or Heteroprime-boost with 10 μg HepB-HP and 20 μg HepB-CHO at 1 and 6months. HBsAg and hepatitis B surface antibody (anti-HBs) fouryears after immunization were quantitatively detected by achemiluminescent microparticle immunoassay (CMIA). Results A total of 359 children were included; 119 childrenreceived two doses of 10 μg HepB-HP and 120 children receivedtwo doses of 20 μg HepB-CHO, called Homo prime-boost; 120children received Hetero prime-boost with 10 μg HepB-HP and 20μg HepB-CHO. All children were HBsAg negative. The geometricmean concentration (GMC) and overall seropositivity rate (SPR) ofanti-HBs were 59.47 (95%CI: 49.00 - 72.16) mIU/ml and 85.51%(307/359). Nearly 15% of the study subjects had an anti-HBsconcentration < 10 mIU/ml and 5.01% had an anti-HBsconcentration ≤ 2.5 mIU/ml. The GMC of the 20 μg CHO Homoprime-boost group [76.05 (95%CI: 54.97 - 105.19) mIU/ml] washigher than that of the 10 μg HP Homo group [45.86 (95%CI:31.94 - 65.84) mIU/ml] (p = 0.035). The GMCs of the Heteroprime-boost groups (10 μg HP-20 μg CHO and 20 μg CHO-10 μgHP) were 75.86 (95% CI: 48.98 - 107.15) mIU/ml and 43.65(95%CI: 27.54 - 69.18) mIU/ml, respectively (p = 0.041). Aftercontrolling for sex influence, the SPR of the 20 μg CHO Homoprime-boost group was 2.087 times than that of the 10 μg HPHomo group. Discussion The HepB booster was not necessary in the generalchildren, Homo/Hetero prime-boost with 20 μg HepB-CHO wouldincrease the anti-HBs concentration four years after immunization,timely testing and improved knowledge about the self-pay vaccinewould be good for controlling hepatitis B.
Collapse
Affiliation(s)
- Zhiying Yin
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Tingcui Wen
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Canya Fu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Junji Li
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Quanjun Fang
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Xiaoying Gong
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Jialing You
- Department of Microbiology, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Shuangqing Wang
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| | - Canjie Zheng
- Department of Immunoprevention, Quzhou Center for Disease Control and Prevention, Quzhou, Zhejiang, China
| |
Collapse
|
2
|
Zhao P, Zhao Y, Du M, Chen X, Lu Y. Impact of lamivudine treatment in late pregnancy on the development of the foetal immune response to hepatitis B virus: a meta-analysis in R with the metafor package. Trans R Soc Trop Med Hyg 2024; 118:264-272. [PMID: 38048279 DOI: 10.1093/trstmh/trad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/15/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is a worldwide public health burden, especially in Asia and Africa. Concerns were raised that foetal exposure to HBV and antiretroviral therapy (ART) might suppress the innate immune response and reduce the production of hepatitis B surface antibody (HBsAb) in foetuses and infants. We therefore conducted the current study to evaluate the impact of ART on the development of the immune response to HBV in foetuses and infants. METHODS We selected lamivudine instead of telbivudine or tenofovir as the intervention measurement because it was the oldest and most widely used ART during pregnancy and its safety data have been sufficiently documented. A comprehensive search was conducted in eight electronic databases, including four Chinese and four English databases. Studies that met the following eligibility criteria were included: human randomized controlled trials (RCTs); participants in the treatment group were exclusively exposed to lamivudine; participants in the control group were exposed to placebo, no treatment or hepatitis B immunoglobulin; all participants were HBV-positive pregnant women with a high viral load and the main outcome of interest was neonatal HBsAb seropositivity. Data were tabulated and analysed using R software. RESULTS Nine RCTs were included and analysed. Compared with controls, lamivudine significantly decreased HBsAb seronegativity in the newborn within 24 h after birth (indicating the foetal immune response to HBV). Similar results were noted in infants within 6-7 months after birth and infants within 12 months (indicating the neonatal immune response to HBV vaccine). CONCLUSIONS Lamivudine treatment in late pregnancy boosted the foetal immune response to HBV in utero and enhanced the neonatal immune response to hepatitis B vaccine after birth.
Collapse
Affiliation(s)
- Peng Zhao
- Department of Obstetrics and Gynaecology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang Province, 310006, Hangzhou, No. 1 Xueshi Road, China
- Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Zhejiang Province, 310006, Hangzhou, No. 1 Xueshi Road, China
| | - Ying Zhao
- Department of Obstetrics, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, 322000, Yiwu, No. N1 Shangcheng Avenue, China
| | - Minmin Du
- Department of Obstetrics, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, 322000, Yiwu, No. N1 Shangcheng Avenue, China
| | - Xiuying Chen
- Department of Obstetrics, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, 322000, Yiwu, No. N1 Shangcheng Avenue, China
| | - Yongchao Lu
- Department of Obstetrics and Gynaecology, Women's Hospital, Zhejiang University School of Medicine, Zhejiang Province, 310006, Hangzhou, No. 1 Xueshi Road, China
| |
Collapse
|
3
|
Ohkubo M, Seo E, Doki K, Suzuki Y, Sekine I, Homma M. Impact of Hepatitis B Surface and Core Antibody Levels on Hepatitis B Virus Reactivation. Biol Pharm Bull 2024; 47:941-945. [PMID: 38735754 DOI: 10.1248/bpb.b23-00907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Hepatitis B virus reactivation (HBV-R) is a serious complication that can occur in patients with resolved HBV infection during cancer chemotherapy. We examined the levels of HBV surface antibody (HBsAb) and HBV core antibody (HBcAb) to assess the incidence of HBV-R in cancer patients including hematopoietic stem cell transplantation (HSCT) and rituximab administration. This retrospective cohort study included 590 patients with resolved HBV infection. The incidence of HBV-R was evaluated 761.5 (range, 90-3898) days after the inititiation of chemotherapy. Of the patients, 13 (2.2%) developed HBV-R after the start of chemotherapy. All 13 patients exhibited lower HBsAb (<100 mIU/mL) levels at baseline. A higher level of HBcAb (≥100 cut off index (C.O.I.)) was a possible risk factor for HBV-R as well as HSCT and rituximab administration. The simultaneous presence of HBsAb <100 mIU/mL and HBcAb ≥100 C.O.I. increased the risk of HBV-R by 18.5%. Patients treated with rituximab were at a higher risk of HBV-R (18.4%) despite having HBcAb <100 C.O.I. Our results suggest that assessment of HBsAb and HBcAb levels prior to the chemotherapy is important for identifying patients at high risk of HBV-R, especially in solid cancers without HSCT and rituximab administration.
Collapse
Affiliation(s)
- Maki Ohkubo
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Department of Pharmacy, University of Tsukuba Hospital
| | - Emiko Seo
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba
| | - Kosuke Doki
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Department of Pharmacy, University of Tsukuba Hospital
| | - Yoshiharu Suzuki
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Department of Pharmacy, University of Tsukuba Hospital
| | - Ikuo Sekine
- Department of Medical Oncology, Faculty of Medicine, University of Tsukuba
| | - Masato Homma
- Department of Pharmaceutical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
- Department of Pharmacy, University of Tsukuba Hospital
| |
Collapse
|
4
|
Chai Y, Tang J, Su Y, Xuan K, Xu L, Hao J, Lu Z, Wang B, Chen X, Luo X, He J, Zhu L. Hepatitis B antibody levels after different doses of hepatitis B vaccination: a retrospective study based on hospitalized children. Epidemiol Infect 2023; 151:e186. [PMID: 37881897 PMCID: PMC10644064 DOI: 10.1017/s0950268823001747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/24/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023] Open
Abstract
Many studies have investigated the positivity rate of hepatitis B surface antibody (HBsAb) after hepatitis B vaccine (HepB) immunization. However, the antibody level, assessed monthly or at more frequent intervals after each of the three doses, particularly within the first year after birth, has not been previously reported. To elucidate the level of antibody formation at various times after vaccination, the current study used the available detection data of HBsAb in hospitalized children to analyze the HBsAb level after immunization combined with their vaccination history. Both the positivity rate and geometric mean concentration (GMC) increased sequentially with immunization doses, reaching their peaks earlier after the third dose than after the first two doses, and the rate of HBsAb positivity was able to reach 100% between 11 and 90 days after completing the three doses of HepB. Within one year after receiving the three doses, the antibody positivity rate and GMC were maintained above 90% and 100 mIU/mL, respectively, and subsequently steadily declined, reaching the lowest value in the 9th and 10th years. The current findings reveal, in more detail, the level of antibody formation at different times following each dose of HepB in hospitalized children, particularly in the age group up to one year after vaccination. For the subjects of this study, we prefer to believe that the proportion of HBsAb non-response should be less than 5% after full immunization with HepB, provided that the appropriate time for blood collection is chosen.
Collapse
Affiliation(s)
- Yu Chai
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jihai Tang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Yin Su
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Kun Xuan
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lili Xu
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
| | - Jiayan Hao
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
| | - Zhijian Lu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - BinBing Wang
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Xia Chen
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Xianwei Luo
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jiali He
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Lijuan Zhu
- Children’s Hospital of Fudan University Anhui Hospital, Heifei, China
| |
Collapse
|
5
|
Terrault NA. Transplanting Kidneys From Donors With Chronic Hepatitis B: Bringing Transmission Risk Closer to Zero. Clin Infect Dis 2021; 72:1024-1025. [PMID: 32095816 DOI: 10.1093/cid/ciaa172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/20/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Norah A Terrault
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
6
|
Wang L, Hu H, Zhang R, Zheng X, Li J, Lu J, Zhang Y, Qi P, Lin W, Wu Y, Yu J, Fan J, Peng Y, Zheng H. Changes in the hepatitis B surface antibody in childhood acute lymphocytic leukaemia survivors after treatment with the CCLG-ALL 2008 protocol. Clin Exp Immunol 2020; 203:80-86. [PMID: 32936935 DOI: 10.1111/cei.13513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 12/13/2022] Open
Abstract
Antibody levels after hepatitis B virus (HBV) vaccination may be affected by suppression of the immune system due to cancer therapy. As such, childhood acute lymphocytic leukaemia (ALL) survivors are at risk of HBV infection due to immunosuppression secondary to chemotherapy. However, the hepatitis B surface antibody (HBsAb)-seropositive rate of childhood ALL survivors after chemotherapy is unknown, and the need to revaccinate HBsAb-seronegative ALL survivors is not appreciated in China. To assess the changes in HBsAb before and after chemotherapy, we retrospectively analyzed clinical data from 547 patients treated with the Chinese Children Leukaemia Group (CCLG)-ALL 2008 protocol from 1 April 2008 to 30 August 2019. The results revealed that 416 patients (76·1%) were HBsAb-seropositive at diagnosis, and at the time of the cessation of chemotherapy, 177 patients (32·4%) were HBsAb-seropositive and 370 patients (67·6%) were HBsAb-seronegative. Interestingly, 11 patients who were HBsAb-seronegative at diagnosis converted to seropositive at the time of the cessation of chemotherapy. HBsAb titres were decreased after chemotherapy (P < 0·0001). Further, patients with higher HBsAb titres at diagnosis were more likely to maintain protective antibody titres at the completion of chemotherapy (P < 0·0001). The loss of antibody was more remarkable in younger patients (≤ 10 years) both at diagnosis (P = 0·009) and at the completion of chemotherapy (P = 0·006). In summary, this study showed that 67·6% of patients were HBsAb-seronegative at the time of the cessation of chemotherapy, which indicates that ALL survivors are at high risk of HBV. As a result, HBV revaccination after chemotherapy should be highly valued in ALL survivors.
Collapse
Affiliation(s)
- L Wang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - H Hu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - R Zhang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - X Zheng
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - J Li
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - J Lu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Y Zhang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - P Qi
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - W Lin
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Y Wu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - J Yu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - J Fan
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Y Peng
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - H Zheng
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics (Capital Medical University), Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| |
Collapse
|
7
|
Abstract
Hepatitis B virus (HBV) vaccination is recommended for health-care professionals because of their frequent contact with blood. At one medical school, new students undergo HBV antibody tests upon admission, and antibody-negative individuals receive the HBV vaccine. We aimed to characterize individuals who remained antibody negative after HBV vaccination. Between 2009 and 2017, we enrolled 1064 first-year students from a medical school where their HBV antibody test and vaccination records remained. We analyzed data regarding the hepatitis B surface antibody (anti-HBs) test record during admission, vaccination record for antibody-negative participants, anti-HBs test result after completing the three vaccination doses, drug name of the vaccine used, sex, body mass index (BMI), and age. We calculated the yearly percentage of antibody-negative individuals and analyzed the characteristics of vaccine-refractory cases by logistic regression analysis. Of the 1064 participants, 999 were initially antibody negative. They were vaccinated with HBV thrice and tested for antibodies after vaccination. The average age of participants was 20.1 y, with 677 males. Although the type of vaccine has been changed since 2016, the average rate of refractoriness from 2009 to 2015 was 6.9% per year and 18.6% after 2016. Logistic regression analyses showed that sex (male vs. female; OR, 1.787), BMI (OR. 1.171), and vaccine type (genotype A vs. genotype C: OR, 3.144) were significant factors associated with antibody-negative individuals. Vaccine type differences altered the proportion of antibody-refractory individuals, with no association with age. The data on vaccine refractoriness will be continuously analyzed in the future while considering other factors.
Collapse
Affiliation(s)
- Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki, Japan.,Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | | |
Collapse
|
8
|
Dong C, Song Z, Chen J, Ma N, Meng X, Sun C, Duan K, Bi B, Wang K, Qin H, Han C, Yang Y, Zhang F, Zheng W, Gao W. Risk factors of de novo hepatitis B virus infection in pediatric hepatitis B core antibody positive liver graft recipients under prophylactic therapy. J Gastroenterol Hepatol 2020; 35:827-832. [PMID: 31609494 DOI: 10.1111/jgh.14869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/20/2019] [Accepted: 09/17/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM We aim to investigate the risk factors of de novo hepatitis B virus (HBV) infection in pediatric liver transplantation recipients receiving hepatitis B core antibody positive grafts and to evaluate the efficacy of our prophylactic strategies. METHODS One hundred thirty-nine pediatric recipients receiving hepatitis B core antibody positive grafts operated from September 2016 to September 2018 were retrospectively enrolled, and all the patients received prophylactic treatment to prevent de novo HBV infection. Donor and recipient features, operative information along with graft, and recipient outcomes were compared between recipients with or without de novo HBV infection. Univariate and multivariate analyses were applied to identify the risk factors of de novo HBV infection. RESULTS The mean follow-up time was 23.5 ± 15.7 months, and the overall incidence of de novo HBV infection was 3.6%. Recipients with de novo HBV infection showed equal graft and recipient outcome compared with the recipients without de novo HBV infection during the follow-up time. Recipient preoperative hepatitis B surface antibody titer of < 1000 IU/L (odds ratio [OR] = 9.652, P = 0.024), graft HBV DNA of > 1000 copies (OR = 9.050, P = 0.032), and intraoperative fresh-frozen plasma transfusion of > 400 mL (OR = 10.462, P = 0.023) were identified as independent risk factors for de novo HBV infection. CONCLUSION Hepatitis B core antibody positive grafts can safely be used in pediatric liver transplantation under rational prophylactic therapy.
Collapse
Affiliation(s)
- Chong Dong
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Zhuolun Song
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Jing Chen
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Nan Ma
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Xingchu Meng
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Chao Sun
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Keran Duan
- Biological Sample Resource Sharing Center, Tianjin First Central Hospital, Tianjin, China
| | - Bowen Bi
- Biological Sample Resource Sharing Center, Tianjin First Central Hospital, Tianjin, China
| | - Kai Wang
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Hong Qin
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Chao Han
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Yang Yang
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Fubo Zhang
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Weiping Zheng
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| | - Wei Gao
- Organ Transplantation Center, Tianjin First Central Hospital, Tianjin, China.,Tianjin Key Laboratory for Organ Transplantation, Tianjin, China
| |
Collapse
|
9
|
Zhang YL, Gao Y, Cao JL, Zhao JH, Zhang TY, Yang CL, Xiong HL, Wang YB, Ou SH, Cheng T, Chen CR, Yuan Q, Xia NS. Robust in vitro assay for analyzing the neutralization activity of serum specimens against hepatitis B virus. Emerg Microbes Infect 2019; 8:724-733. [PMID: 31130075 PMCID: PMC6542156 DOI: 10.1080/22221751.2019.1619485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Anti-HBs is a well-known marker of protective capability against HBV. However, little is known about the association between the qAnti-HBs determined by immunoassays and the neutralization activity (NAT) derived from functional assays. We developed an in vitro assay for direct measurement of the NAT of human sera. The new assay was highly sensitive, with an analytical sensitivity of 9.6 ± 1.3 mIU/mL for the HBIG standard. For serum detection, the maximum fold dilution required to produce ≥50% inhibition (MDF50) of HBV infection was used as the quantitative index. In vitro NAT evaluations were conducted for a cohort of 164 HBV-free healthy individuals. The results demonstrated that the NAT positively correlated with the qAnti-HBs (R2 = 0.473, p < 0.001). ROC analysis indicated that the optimal cutoff value of the qAnti-HBs to discriminate significant NAT (MDF50 ≥ 8) was 62.9 mIU/mL, with an AUROC of 0.920. Additionally, we found that the qAnti-HBc was another independent parameter positively associated with the NAT (R2 = 0.300, p < 0.001), which suggested that antibodies against other HBV proteins generated by previous HBV exposure possibly also contribute to the NAT. In summary, the new cell-based assay provides a robust tool to analyse the anti-HBV NAT. Abbreviations: HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; Anti-HBs: Hepatitis B surface antibody; HBeAg: Hepatitis B e antigen; Anti-HBc: Hepatitis B core antibody; qAnti-HBs: quantitative hepatitis B surface antibody; qAnti-HBc: quantitative hepatitis B core antibody; qHBeAg: quantitative hepatitis B e antigen; NAT: neutralization activity; HBIG: hepatitis B immune globulin; NTCP: Na+-taurocholate cotransporting polypeptide; IRES: internal ribosome entry site; ccHBV: cell culture derived hepatitis B virus; GE/cell: genome equivalent per cell; MOI: multiplicity of infection; Dpi: day post infection; HepG2-TetOn: a HepG2-derived cell line that expresses the doxycycline-regulated transactivator; ROC: receiver operating characteristic curve; AUROC: area under receiver operating characteristic curve; LLOQ: the lower limits of quantification; MDF50: the maximum fold dilution required to produce ≥50% inhibition; IC50: half maximal inhibitory concentration.
Collapse
Affiliation(s)
- Ya-Li Zhang
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Ying Gao
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,d Hainan Health Disseminate Centre , Haikou , People's Republic of China
| | - Jia-Li Cao
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Jing-Hua Zhao
- b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China.,e Natural Medicine Institute of Zhejiang Yangshengtang , Hangzhou , People's Republic of China
| | - Tian-Ying Zhang
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Chuan-Lai Yang
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Hua-Long Xiong
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Ying-Bin Wang
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Shan-Hai Ou
- c Xiamen Blood Service , Xiamen , People's Republic of China
| | - Tong Cheng
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Chang-Rong Chen
- f Xiamen Haicang Hospital , Xiamen , People's Republic of China
| | - Quan Yuan
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| | - Ning-Shao Xia
- a State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics , School of Public Health, Xiamen University , Xiamen , People's Republic of China.,b School of Life Science , National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Xiamen University , Xiamen , People's Republic of China
| |
Collapse
|
10
|
Kalantari H, Ferdowsi F, Yaran M. Prevalence of occult hepatitis B virus infection in hemodialysis patients in Isfahan, Iran. Adv Biomed Res 2016; 5:151. [PMID: 27713872 PMCID: PMC5046800 DOI: 10.4103/2277-9175.188487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 03/09/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The absence of a detectable hepatitis B surface antigen (HBsAg) with or without hepatitis B core antibody (anti-HBc) or hepatitis B surface antibody (anti-HBs) in the presence of hepatitis B virus-DNA (HBV-DNA) is defined as occult HBV infection. This study was aimed to evaluate the prevalence of occult HBV infection in patients receiving hemodialysis (HD) in Isfahan, Iran. MATERIALS AND METHODS This cross sectional study was done on 400 patients without acute or chronic HBV infection with end-stage renal disease undergoing regular HD. Blood samples were collected prior to the HD session, and serological markers of viral hepatitis B included HBsAg, anti-HBs and anti-HBc were measured using standard third generation commercially available enzyme immunoassays kit, then samples of positive anti-HBc and negative anti-HBs were tested for HBV DNA using quantitative real-time polymerase chain reaction techniques. Data were analyzed by SPSS using t-test and Chi-square test. RESULTS The mean age of patients was 51.6 ± 11.2 years. Anti-HBc positive was observed in 32 (8%) of 400 studied patients with negative HBsAg. Of 32 patients with anti-HBc positive, 15 were males and 17 were females with mean age of 49.7 ± 12.6 years. Among 32 patients with anti-HBc positive, 10 patients were negative for anti-HBs. All of 10 patients were negative for HBV DNA. The prevalence of occult HBV infection was 0%. CONCLUSIONS The prevalence of occult HBV infection in HBsAg negative patients undergoing HD was 0% and look to be among the lowest worldwide. So, occult HBV infection is not a significant health problem in HD patients in this region.
Collapse
Affiliation(s)
- Hamid Kalantari
- Department of Gastroenterology, Isfahan Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Faezeh Ferdowsi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
11
|
Yilmaz B, Erdem D, Teker F, Goren I, Yildirim B, Kut E, Sarikaya D, Atay MH, Yucel I. The effect of anticancer therapy on anti-hepatitis B antibody titres in patients with haematological malignancies and solid tumours. J Int Med Res 2016; 44:627-38. [PMID: 27048386 PMCID: PMC5536710 DOI: 10.1177/0300060516638992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/23/2016] [Indexed: 12/22/2022] Open
Abstract
Objective To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours. Methods This retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections. Results The medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherapy (67 mIU/ml versus 33 mIU/ml) following chemotherapy, whereas there was no significant change in patients with solid tumours. After chemotherapy, patients with low pretreatment anti-HBs titres (<100 mIU/ml) were more likely to become seronegative (<10 mIU/ml). Conclusion High levels of anti-HBs may have a protective effect against the reactivation of HBV especially in patients with haematological malignancies who received immunosuppressive anticancer therapy.
Collapse
Affiliation(s)
- Bahiddin Yilmaz
- Department of Medical Oncology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Dilek Erdem
- Division of Medical Oncology, Medical Park Hospital, Samsun, Turkey
| | - Fatih Teker
- Division of Medical Oncology, Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey
| | - Ibrahim Goren
- Department of Gastroenterology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Beytullah Yildirim
- Department of Gastroenterology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Engin Kut
- Department of Medical Oncology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Derya Sarikaya
- Department of Medical Oncology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Memis H Atay
- Department of Haematology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Idris Yucel
- Department of Medical Oncology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| |
Collapse
|
12
|
Li M, Zhou H, Guan Y, Peng H, Wang S, Zhang P, Su B. Positive hepatitis B surface antibody is associated with reduced risk of diabetes mellitus in retired female Chinese workers. J Diabetes 2016; 8:158-61. [PMID: 26016384 DOI: 10.1111/1753-0407.12317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 05/18/2015] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND To study the relationship between positivity for hepatitis B surface antibody (HBsAb) and the risk of diabetes mellitus in the retired Chinese population. METHODS A cross-sectional analysis was conducted in 900 retired Chinese workers attending a health check-up program. HBsAb, hepatitis B surface antigen, oral glucose tolerance test (OGTT), fasting plasma glucose (FBG), 2-h plasma glucose 2hBG, and insulin levels were collected. RESULTS Participants positive for HBsAb were younger, with lower blood pressure, lower FBG and 2hBG serum uric acid, and glutamic pyruvic transaminase than those who were HbsAb negative. There were 306 subjects with impaired glucose tolerance and 121 with type 2 diabetes (T2D) in the present cohort. Using Chi-squared analysis to assess the risk of diabetes, women positive for HBsAb had a lower prevalence of T2D than those negative for HBsAb (15.7% vs 26.5%, respectively; P < 0.01). Multivariate analysis revealed family history of diabetes, age, and waist circumference were independently associated with a higher prevalence of diabetes, and that HBsAb positivity was independently associated with a lower prevalence of diabetes (odds ratio 0.579; 95% confidence interval 0.388-0.918) when adjusted for sex, family history of hypertension and dyslipidemia, and body mass index. CONCLUSIONS An HBsAb-positive status is associated with a low rate of diabetes and better metabolic status. A prospective study of patients with known vaccination records is needed to investigate whether hepatitis B virus vaccination could protect against the development of diabetes.
Collapse
Affiliation(s)
- Ming Li
- Department of Microecology, School of Basic Medical Science, Dalian Medical University, Dalian, China
| | - Hui Zhou
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- Department of Endocrinology and Metabolism, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, Chengdu, China
| | - Yufeng Guan
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haiying Peng
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shunyu Wang
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ping Zhang
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Benli Su
- Department of Endocrinology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
13
|
Motaparthi K, Stanisic V, Van Voorhees AS, Lebwohl MG, Hsu S. From the Medical Board of the National Psoriasis Foundation: Recommendations for screening for hepatitis B infection prior to initiating anti-tumor necrosis factor-alfa inhibitors or other immunosuppressive agents in patients with psoriasis. J Am Acad Dermatol 2013; 70:178-86. [PMID: 24220724 DOI: 10.1016/j.jaad.2013.08.049] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/14/2013] [Accepted: 08/24/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND No consensus exists regarding the optimal laboratory screening for hepatitis B infection that should be performed before initiating therapy with tumor necrosis factor-alfa inhibitors or other immunosuppressive agents. OBJECTIVE We sought to give guidelines on which tests to order for hepatitis B screening. METHODS We review the pathophysiology and serology of hepatitis B infection and provide recommendations for screening for hepatitis B infection in patients with psoriasis before beginning anti-tumor necrosis factor-alfa therapy or other immunosuppressive agents. RESULTS We propose the standardized use of triple serology testing: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody in combination with liver function tests as screening. LIMITATIONS Conclusions based on review of available literature is a limitation. CONCLUSIONS All patients with psoriasis who are candidates for tumor necrosis factor-alfa inhibitor should undergo screening for hepatitis B virus infection using the triple serology: hepatitis B surface antigen, hepatitis B surface antibody, and hepatitis B core antibody. It is advisable that patients, who are candidates for ustekinumab, cyclosporine, or methotrexate undergo the same screening.
Collapse
Affiliation(s)
- Kiran Motaparthi
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | - Vladimir Stanisic
- Department of Dermatology, Baylor College of Medicine, Houston, Texas
| | | | | | - Sylvia Hsu
- Department of Dermatology, Baylor College of Medicine, Houston, Texas.
| | | |
Collapse
|
14
|
Ren ZQ, Liu TC, Hou JY, Chen MJ, Chen ZH, Lin GF, Wu YS. A rapid and sensitive method based on magnetic beads for the detection of hepatitis B virus surface antigen in human serum. LUMINESCENCE 2013; 29:591-7. [PMID: 24136927 DOI: 10.1002/bio.2587] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 06/17/2013] [Accepted: 08/15/2013] [Indexed: 12/17/2022]
Abstract
Current clinically assays, such as enzyme-linked immunosorbent assay and chemiluminescence immunoassay, for hepatitis B surface antigen (HBsAg) are inferior in terms of either sensitivity and accuracy or rapid and high-throughput analysis. A novel assay based on magnetic beads and time-resolved fluoroimmunoassay was developed for the quantitative determination of HBsAg in human serum. HBsAg was captured using two types of anti-HBsAg monoclonal antibodies (B028, S015) immobilized on to magnetic beads and detected using europium-labeled anti-HBsAg polyclonal detection antibody. Finally, the assay yielded a high sensitivity (0.02 IU/mL) and a wide dynamic range (0.02-700 IU/mL) for HBsAg when performed under optimal conditions. Satisfactory accuracy, recovery and specificity were also demonstrated. The intra- and interassay coefficients of variation were 4.7-8.7% and 3.8-7.5%, respectively. The performance of this assay was further assessed against a well-established commercial chemiluminescence immunoassay kit with 399 clinical serum samples. It was revealed that the test results for the two methods were in good correlation (Y = 1.182X - 0.017, R = 0.989). In the current study, we demonstrated that this novel time-resolved fluoroimmunoassay could be used: as a highly sensitive, automated and high-throughput immunoassay for the diagnosis of acute or chronic hepatitis B virus infection; for the screening of blood or organ donors; and for the surveillance of persons at risk of acquiring or transmitting hepatitis B virus.
Collapse
Affiliation(s)
- Zhi-Qi Ren
- Institute of Antibody Engineering, School of Biotechnology, Southern Medical University, Guangzhou, 510515, Guangdong, People's Republic of China
| | | | | | | | | | | | | |
Collapse
|
15
|
Wesdorp DJW, Knoester M, Braat AE, Coenraad MJ, Vossen ACTM, Claas ECJ, van Hoek B. Nucleoside plus nucleotide analogs and cessation of hepatitis B immunoglobulin after liver transplantation in chronic hepatitis B is safe and effective. J Clin Virol 2013; 58:67-73. [PMID: 23880162 DOI: 10.1016/j.jcv.2013.06.035] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/23/2013] [Accepted: 06/26/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND After orthotopic liver transplantation (OLT) in chronic hepatitis B (HBV), adequate prophylaxis for recurrence of HBV in the graft is mandatory. OBJECTIVES Evaluate safety of HBV prophylaxis with tenofovir and emtricitabine (TDF/FTC) after cessation of hepatitis B immunoglobulin (HBIG) after OLT in chronic HBV. STUDY DESIGN In 17 consecutive patients after OLT in chronic HBV we started TDF/FTC after cessation of HBIG. All had received HBIG >6 months. 15/17 were HBsAg negative and 16/17 had undetectable HBV-DNA. RESULTS After mean follow-up of 2 years 16/17 patients were alive, one died due to urosepsis. All 16 with undetectable HBV-DNA remained HBV-DNA negative. From 15 HBsAg negative patients at start, in one seroconversion to positive HBsAg occurred, without detectable HBV-DNA. Liver biochemistry remained within the normal ranges. There were no cases of drug discontinuation. No major side effects were reported. TDF/FTC use saves €16,262/year over standard-of-care (HBIG+LAM). This prospective follow-up study shows that in liver transplantation for chronic hepatitis B, after initial treatment including HBIG for at least 6 months combined with or followed by (dual) nucleos(t)ide analog therapy, TDF/FTC provides adequate prophylaxis against recurrent HBV infection without major side effects and leads to substantial cost savings over a regimen with HBIG. CONCLUSION Combined prophylaxis with TDF/ETV nucleoside plus nucleotide analogs and cessation of immunoglobulin after liver transplantation in chronic hepatitis B is safe and effective.
Collapse
Affiliation(s)
- D J W Wesdorp
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | | | | | | | | |
Collapse
|