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发表于 2005-3-19 00:09
Progressive disappearance of anti-hepatitis B surface antigen antibody and
reverse seroconversion after allogeneic hematopoietic stem cell
transplantation in patients with previous hepatitis B virus infection.
Onozawa M, Hashino S, Izumiyama K, Kahata K, Chuma M, Mori A, Kondo T,
Toyoshima N, Ota S, Kobayashi S, Hige S, Toubai T, Tanaka J, Imamura M,
Asaka M.
1 Department of Gastroenterology and Hematology, Hokkaido University
Graduate School of Medicine, Sapporo, Japan. 2 Department of Hematology and
Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Reactivation of resolved hepatitis B virus (HBV) infection, which is known
as reverse seroconversion (RS), has been reported as a rare complication of
allogeneic hematopoietic stem cell transplantation. We retrospectively
studied HBV serologic markers in 14 recipients with pretransplant
anti-hepatitis B surface antigen antibody (anti-HBs). Progressive decreases
in anti-HBs titer were observed in all cases. In 12 cases, anti-HBs titer
had decreased to under the protective value. RS occurred in seven cases
after disappearance of anti-HBs. Although reseroconversion occurred in five
cases, two cases remained in an HBV-carrier status after resolution of
hepatitis. In the other five cases, RS did not occur even after
disappearance of anti-HBs. The actual risks of anti-HBs disappearance and RS
were estimated to be 75.0% and 39.8% at 2 years and 100.0% and 70.0% at 5
years, respectively. In conclusion, RS is a late-onset complication with
high frequency that can be predicted by careful monitoring of progressive
decrease in anti-HBs titer.
PMID: 15753855 [PubMed - in process]
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