Assessment of hepatitis B surface antibody in children after allogeneic
peripheral blood stem cell transplantation and impact of donor/recipient
immunity on hepatitis B surface antibody disappearance
Abstract
After allogeneic peripheral blood stem cell transplantation (PBSCT),
children are at high risk of hepatitis B virus (HBV) infection because
of the potential loss of HBV immunity. The factors which can affect it
are not fully understand. This study aimed to assess the probability of
hepatitis B surface antibody (HBsAb) disappearance after PBSCT and to
evaluate the impact of donor and recipient immunity on HBsAb
disappearance. A total of 110 patients who underwent PBSCT between
January 2016 and December 2018 and their paired donors were
retrospectively enrolled in this study. Before transplantation, 87
(79.1%) patients were HBsAb seropositive, and 23 (20.9%) were HBsAb
seronegative. Fifty-five (63.2%) patients with protective HBsAb titers
before PBSCT lost their HBV immunity within one year after
transplantation. Univariate analysis showed that the low recipient
pretransplant HBsAb titer, antithymocyte globulin (ATG) administration,
corticosteroid administration and graft-versus-host disease (GVHD) were
significant risk factors for HBsAb disappearance (P<0.05).
Multivariate analysis showed that only recipient pretransplant HBsAb
titers lower than 207.5 IU/L (P=0.022, hazard ratio (HR): 1.925, 95%
confidence interval (CI): 1.101-3.367) and the presence of GVHD
(P=0.033, HR=1.921, 95% CI: 1.056-3.495) were risk factors for HBsAb
disappearance one year after HSCT. In conclusion, most recipients lost
previously acquired immunity to HBV after PBSCT. A high titer of HBsAb
in the recipient before transplantation had a protective effect against
posttransplant HBsAb disappearance, but the presence of donor immunity
did not significantly influence the maintenance of recipient immunity to
HBV.