Kaloyannidis Panayotis, Batsis Ioannis, Yannaki Evangelia, Adamidou Despina, Bartzoudis Dimitrios, Papathanasiou Maria, Mallouri Despina, Sakellari Ioanna, Fassas Athanasios, Anagnostopoulos Achilles
Hematology Department, BMT-Unit, George Papanicolaou Hospital, Thessaloniki, Greece.
Biol Blood Marrow Transplant. 2007 Sep;13(9):1049-56. doi: 10.1016/j.bbmt.2007.05.009. Epub 2007 Jul 16.
Immunized against hepatitis B virus (HBV) recipients are at risk of developing HBV postallogeneic stem cell transplantation because of the potential loss of their HBV immunity. The aim of the study was to evaluate: (1) the HbsAb eradication incidence posttransplant and potential risk factors, (2) the impact of donor's immunity on HbsAb loss, (3) the incidence of hepatitis B in patients with HbsAb disappearance. We studied, retrospectively, in 26 vaccinated and 56 naturally immunized recipients, the posttransplant HbsAb titers for a median period of 36 (6-132) months. The probability of HbsAb loss and HBV-related hepatitis was determined in all recipients. The impact of donor's immunity origin in the HBsAb disappearance was evaluated in the subgroup of, actively or naturally, immunized recipients/donors pairs. The 5-year probability of HbsAb disappearance was 90% for all patients with 18% probability of developing hepatitis at 12 years, for those who lost HbsAb. Marrow graft, antithymocyte globulin administration, age<30 years and chronic graft-versus-host disease were significant risk factors for HbsAb loss. In the subgroup of immunized recipients/donors, the donor's active immunization significantly affected this loss. Allotransplanted patients are at high risk of losing protection against HBV. The adoptive transfer of active HBV immunity does not seem to offer sustained protection posttransplant.
接种过乙肝病毒（HBV）疫苗的异基因造血干细胞移植受者存在HBV免疫力丧失的风险，因而有发生移植后HBV感染的可能。本研究旨在评估：（1）移植后乙肝表面抗体（HbsAb）消失的发生率及潜在危险因素；（2）供者免疫状态对HbsAb消失的影响；（3）HbsAb消失患者的乙肝发生率。我们对26例接种过疫苗和56例自然免疫的受者进行了回顾性研究，观察其移植后HbsAb滴度，中位观察期为36（6 - 132）个月。测定了所有受者HbsAb消失及HBV相关肝炎的发生率。在主动或自然免疫的受者/供者对亚组中，评估供者免疫状态对HbsAb消失的影响。所有患者HbsAb消失的5年发生率为90%，HbsAb消失者12年发生肝炎的概率为18%。骨髓移植、使用抗胸腺细胞球蛋白、年龄<30岁和慢性移植物抗宿主病是HbsAb消失的显著危险因素。在免疫的受者/供者亚组中，供者的主动免疫显著影响HbsAb消失。接受同种异体移植的患者有失去HBV免疫保护的高风险。主动HBV免疫的过继转移似乎不能在移植后提供持续的保护。
