Hepatitis B Reactivation Among Non-Liver Solid Organ Transplant Recipients.
Multi-Organ Transplant Program, Transplant Infectious Diseases, University Health Network, University of Toronto, Toronto, ON, Canada.
Meeting: 2016 American Transplant Congress
Abstract number: C290
Keywords: Hepatitis B, Kidney transplantation, Lung transplantation, Mortality
Session Information
Session Name: Poster Session C: Viruses and SOT
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Introduction
The purpose of this study was to evaluate the incidence of post-transplant hepatitis B (HBV) reactivation in patients who have previously cleared hepatitis B surface antigen (HBsAg) and to compare survival rates between patients with or without HBV reactivation.
Methods
Five hundred and eleven non-liver transplant recipients were identified from July 1999 until April 2015. Only recipients who were hepatitis B core antibody (HBcAb)-positive and had no evidence of active viral replication (surface antigen negative) prior to transplantation were included in the study. 122 patients met inclusion criteria. The primary and secondary outcomes were HBV reactivation post-transplant (conversion to HBsAg positivity and/or DNA positivity) and mortality, respectively. Logistic regression and simple correlation were used to identify risk factors for HBV reactivation during the post-transplant period.
Results
The mean age of the cohort was 53.9 ± 10.5 years, 63.9% were males and transplant types were kidney (n=77; 63.1%), lung (n=36; 29.5%), heart (n=7; 5.7%), and kidney/pancreas (n=2; 1.6%). Among the 122 patients, 21 were anti-HBs antibody (HBsAb) negative. Only 11 patients received anti-HBV prophylaxis of which 6 were anti-HBsAb positive and 5 were anti-HBsAb negative; none of the HBV-reactivated patients received prophylaxis. HBV reactivation prevalence was 4.1%. Median time to reactivation was 4.7 years post-transplant. Five-year survival was 82% in the overall cohort. The cumulative freedom from HBV reactivation at five-year post-transplant was 94.9% in patients without pre-transplant anti-HBs antibodies as compared to 97.4% in those with pre-transplant anti-HBs antibodies. The potential risk factors of HBV reactivation are outlined below (Table 1). No deaths were observed in those patients who experienced HBV reactivation.
Table 1. Univariate Logistic Regression for HBV Reactivation
| Odds Ratio | Confidence Interval | P value | |
| Age | 1.04 | 0.95-1.15 | 0.371 |
| HBs Ab + (pre-transplant) | 0.82 | 0.09-7.77 | 0.866 |
| HBs Ab + (post-transplant) | 1.0 | 0.21-4.75 | 1.00 |
| Allograft rejection | 0.66 | 0.07-6.17 | 0.719 |
Conclusions
Our study suggests that, in non-liver transplant recipients who are hepatitis B core antibody positive pre-transplant, the rate of reactivation is relatively low and is not associated with higher mortality.
CITATION INFORMATION: Gonzalez A, Forouton F, Humar A, Husain S. Hepatitis B Reactivation Among Non-Liver Solid Organ Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Gonzalez A, Forouton F, Humar A, Husain S. Hepatitis B Reactivation Among Non-Liver Solid Organ Transplant Recipients. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/hepatitis-b-reactivation-among-non-liver-solid-organ-transplant-recipients/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress