Changes of hepatitis B virus serologic status after allogeneic hematopoietic stem cell transplantation and impact of donor immunity on hepatitis B virus

Reverse seroconversion (RS) of Hepatitis B virus (HBV) has been reported after allogeneic transplantation with an incidence of 14% to 86%. However, most prior studies on HBV RS were performed in HBV nonendemic areas. In this study, the frequency of HBV RS at a single center in Korea, endemic for HBV, was evaluated. Also, the influence of the donor's immunity for HBV on posttransplantation HBV serologic changes in recipients was also investigated. A total of 288 patients underwent allogeneic transplantation between February 1996 and June 2008. We retrospectively reviewed the medical records of 288 patients and their paired donors. Among the 268 HBsAg(-) patients, 205 were assessed for posttransplantation HBsAg, and 114 (55.6%) of 205 had HBcAb before transplantation. With a median follow-up of 77.9 months, 3 of 114 patients experienced HBV RS (2.6%). With regard to donor immunity, significantly more patients with anti-HBs(-) donors experienced anti-HBs loss (P = .006), and the donor anti-HBs showed significant protective effects against the anti-HBs loss with an HR of 0.4. HBV RS after allogeneic transplantation may not be as common in HBV endemic areas. Also, donor anti-HBs showed a significant favorable effect on maintaining HBV immunity in recipients.