造血干细胞移植后乙型肝炎表面抗原反向血清转换与基线血清学标志物水平和疫苗接种情况有关:单中心数据库分析。

IF 2.3 Q2 HEMATOLOGY
Soo Young Kang, Heejoo Ko, Raeseok Lee, Sung-Soo Park, Seunghoon Han
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引用次数: 0

摘要

目的:乙型肝炎是造血干细胞移植(HSCT)后的一个主要预后因素。目前,对于可能导致乙型肝炎表面抗原(HBsAg-RS)逆转血清转换的各种情况的处理方法尚未达成共识。本研究的重点是作为活动性肝炎指标的 HBsAg-RS,旨在获得与患者和治疗因素相关的探索性信息:这项单中心回顾性研究利用了从韩国首尔圣玛丽医院电子病历中提取的临床数据。研究纳入了在2013年1月至2018年12月期间接受造血干细胞移植且在接受造血干细胞移植前乙肝表面抗原(HBsAg)检测呈阴性的患者。对HBsAg-RS与人口统计学信息、基线乙型肝炎血清学标志物和疫苗接种情况之间的关联进行了统计分析:本研究共纳入 1,344 名患者,其中 83.3% 的患者在造血干细胞移植过程中乙肝表面抗体 (HBsAb) 检测呈阳性。HBsAb阴性患者中有2.2%出现HBsAg-RS,HBsAb阳性患者中有3.0%出现HBsAg-RS,这表明不同HBsAb状态的再活率没有显著差异。然而,乙型肝炎核心抗体(HBcAb)阳性与乙型肝炎再活化有显著相关性(HBsAg-RS 率:8.0%)。HBsAb和HBcAb均为阴性的患者接种率最高,并具有短暂的保护作用:充足的患者群体使我们能够确定基线 HBcAb 阳性与 HBsAg-RS 发展之间的关联。有必要进一步开展前瞻性研究,以确定预防 HBsAg-RS 的最佳疫苗接种策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hepatitis B surface antigen reverse seroconversion after hematopoietic stem cell transplantation according to the baseline serological marker levels and vaccination status: a single-center database analysis.

Purpose: Hepatitis B is a major prognostic factor after hematopoietic stem cell transplantation (HSCT). Currently, no consensus exists regarding the management of various scenarios that can lead to reverse seroconversion of the hepatitis B surface antigen (HBsAg-RS). This study focused on HBsAg-RS, which serves as an indicator of active hepatitis, and aimed to obtain exploratory information on the associated patient and treatment factors.

Methods: This single-center retrospective study utilized clinical data extracted from the electronic medical records of Seoul St. Mary's Hospital, Korea. Patients who underwent HSCT between January 2013 and December 2018 and tested negative for hepatitis B surface antigen (HBsAg) before undergoing HSCT were included. The associations between HBsAg-RS and demographic information, baseline hepatitis B serological markers, and vaccination status were statistically analyzed.

Results: This study included 1,344 patients, of whom 83.3% tested positive for the hepatitis B surface antibody (HBsAb) during HSCT. HBsAg-RS occurred in 2.2% of HBsAb-negative patients and 3.0% of HBsAb-positive patients, indicating no significant difference in reactivation rates according to HBsAb status. However, positivity for hepatitis B core antibody (HBcAb) was significantly associated with hepatitis B reactivation (HBsAg-RS rate: 8.0%). The vaccination rates were highest in patients who were negative for both HBsAb and HBcAb and had a transient protective effect.

Conclusion: The sufficient patient population enabled the identification of an association between baseline HBcAb positivity and the development of HBsAg-RS. Further prospective studies are warranted to determine optimal vaccination strategies for preventing HBsAg-RS.

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来源期刊
Blood Research
Blood Research HEMATOLOGY-
CiteScore
3.70
自引率
0.00%
发文量
64
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