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Hepatitis B Virus Infection in Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation.

Authors :
Liu, Yi-Chang
Hsu, Chi-Mu
Hsiao, Samuel Yien
Hsiao, Hui-Hua
Source :
Journal of Personalized Medicine. Nov2021, Vol. 11 Issue 11, p1108-1108. 1p.
Publication Year :
2021

Abstract

Considering a steady increase in the number of allogeneic hematopoietic stem cell transplantations (allo-HSCT) worldwide and the significant proportion of the world's population that has been exposed to hepatitis B virus (HBV) infection, HBV reactivation following allo-HSCT remains an important issue for post-transplant morbidity and mortality. Antiviral prophylaxis can reduce HBV replication, severity of HBV-related hepatitis, and mortality; therefore, identification of patients at risk is crucial. It is recommended that all recipients and donors should be screened for active or prior HBV infection, including HBsAg, antiHBc, and antiHBs. Adoptive immunity transfer from the donor seems to have protective effects against HBV reactivation. Antiviral prophylaxis should be initiated in all HBsAg-positive patients. HBsAg-negative, antiHBc-positive patients remain at risk; therefore, antiviral prophylaxis should be considered if baseline serum HBV DNA is detectable. In HBsAg-negative, antiHBc-positive patients without detectable HBV DNA, close monitoring of viral load with an on-demand therapy is necessary. Entecavir or tenofovir rather than lamivudine are more appropriate for the emergence of lamivudine resistance. The treatment duration remains unclear, with 6- to 12-month therapy after cessation of immunosuppressive therapy commonly recommended. Here we review the updated evidence and recent recommendations regarding HBV reactivation in patients undergoing allo-HSCT for individualized therapy. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20754426
Volume :
11
Issue :
11
Database :
Academic Search Index
Journal :
Journal of Personalized Medicine
Publication Type :
Academic Journal
Accession number :
153896489
Full Text :
https://doi.org/10.3390/jpm11111108