Abstract:

Objective China has a high incidence of hepatitis B virus （HBV）infection，and HBV infection is still a major liver complication after hematopoietic stem cell transplantation（HSCT）. Previous studies have focused on viral reactivation and reverse seroconversion after HSCT，but there are few studies on whether HSCTaffects the serological status of HBV in non-HBV infected recipients. Methods We retrospectively reviewed the HBV serological test records of 50 patients before and after HSCT，without previous or present HBV infection，and compared the titers of hepatitis B surface antibody（HBsAb）.  Results  In 50 HSCT patients，the median HBsAb titer before HSCT was 36.69（6.67 ~ 237.0）U/L，and the antibody titer after HSCT was significantly lower than that before transplantation〔14.23，（3.07 ~ 77.76））U/L，P ＜ 0.001〕. We further analyzed the effects of auto-HSCT and allo-HSCT on HBsAb. In 31 patients with auto- HSCT，the HBsAb titer before HSCT was 33.44（6.29 ~ 221.5）U/L，and the antibody titer after HSCT was significantly lower than that before HSCT〔16.65（3.20 ~ 69.51）U/L，P ＝ 0.001〕. In19 patients with allo- HSCT，the HBsAb titer before transplantation was 39.94（6.79 ~ 499.80）U/L，and the antibody titer after HSCT was also significantly lower than that before HSCT〔13.0（2.40 ~ 102.0）U/L，P ＝ 0.036〕. Inaddition，antibody loss was found in 3 patients with auto- HSCT and 4 patients with allo- HSCT. Conclusion The titer of HBsAb decreased significantly after HSCT，and the antibody disappeared in some patients. In HSCT patients，close monitoring of HBsAb titers and appropriate booster vaccination are essential.

Key words: Hematopoietic stem cell transplantation, Hepatitis B virus, Hepatitis B surface antibody

摘要：

目的 中国是乙型肝炎病毒（hepatitis B virus，HBV）感染的高发区，HBV 感染仍然是进行造血干细胞移植（hematopoietic stem cell transplantation，HSCT）的主要肝脏并发症。既往研究的重点在HSCT 后 HBV 的再激活以及血清逆转，对 HSCT 是否会影响非 HBV 感染受者的 HBV 血清学状态的研究较少。方法 我们回顾性研究了 50 例无 HBV 感染的患者在接受 HSCT 治疗前后 HBV 血清学检测记录，并对移植前后乙型肝炎表面抗体（hepatitis B surface antibody，HBsAb）滴度进行了比较。结果 在 50 例移植患者中，移植前 HBsAb 滴度中位数为 36.69（6.67 ~ 237.0）U/L ，移植后抗体滴度明显低于移植前〔14.23（3.07 ~77.76）U/L，P ＜ 0.001〕。我们分别对自体移植和异基因移植对 HBsAb 的影响进行分析。在 31 例自体移植患者中，移植前患者的平均 HBsAb 滴度为 33.44（6.29 ~ 221.5）U/L，移植后抗体滴度明显低于移植前〔16.65（3.20 ~ 69.51）U/L，P ＝ 0.001〕；在 19 例异基因移植患者中，移植前患者的平均 HBsAb 滴度为39.94（6.79 ~ 499.80）U/L，移植后抗体滴度也明显低于移植前〔13.0（2.40 ~ 102.0）U/L，P ＝ 0.036〕。此外，在自体移植患者中，有 3 例患者存在抗体丢失 ；异基因移植患者中，有 4 例抗体丢失。结论 HSCT 移植后HBsAb 滴度显著降低，部分患者存在抗体的丢失。在接受 HSCT 患者中，密切监测 HBsAb 滴度以及适当的加强免疫接种是至关重要的。

关键词: 造血干细胞移植 , 乙型肝炎病毒 , 乙型肝炎表面抗体