The Impact Of Hepatitis B Virus Infected Patients On The Clinical Outcome Of Hematopoitic Stem Cell Transplantation

Objective: to analyze the impact of patients infected with hepatitis B virus on the clinical outcome of hematopoietic stem ?eli transplantation. Methods: we investigated retrospectively the transplantation outcome of 48 patients infe-cted with hepatitis B virus prior to transplantation among 185 patients of hem-atopoietic stem celi transplantation (HSCT).Results: The incidences of HBsAg (+) and HBV infection( excepting only HbsAb(+)) were7.02% and 25.95% respectively. There was no significant difference in the engraftment of hemato-poietic stem cells between HBV infected group and control group, For WBC in peripheral blood reaching up to 1X109/L,it needed an average time of 14.54 days on the patients with HBV infection after HSCT. During a follow-up of 180 days after HSCT, in AHSCT group, ALT values of the patients of HBs-Ag(+) group, HBsAb(+) group and control group were 281.6±414.6 U/L, 95.4±79.9 U/L and 65.1±44.2U/L respectively.The incidences of abnormal liver function of the patients of HBsAg(+) group, HBsAb(+) group and control group were 55.56%> 30.77% and 15.38% respectively0 The incidences of hepatitis of the patients of HBsAg(+) group, HBsAb(+) group and the control group were 44.44%> 30.77% and 14.81% respectively; There were significant difFerences in the incidences of hepatitis, abnormal liver function and ALT average values of the patients betvveen HBsAg(+) group and control group (P<0.05), There were no significant differences betvveen any other two group. In allo-HSCT group, ALT values of the patients of HBsAg(+) group, HBsAb(+) group and control group were 572.6+744.7 U/L, 244.2 ±262.8 U/L and 188.9±238.2U/L respectively.The incidences of abnormal liver function of the patients of HBsAg(+) group, HBsAb(+) group and control group were 75% > 66.7% and 53.33% respectively0 The incidences of hepatitis of the patients of HBsAg(+) group, HBsAb(+) group and the control group were 75%> 55.55% and 46.67% respectively; There were significant differences between any two groups of these three groups .There was no ace to develop VOD after HSCT. There was no significant difference in GVHD between HBV infection group and control group(P>0.05). Two patients developed acute hepatitis B in 3 months after transplantation with severe impaired liver function,however, they completely recovery from acute hepatitis B.the death of those patients at late period after transplantation was not related to HBV infection. Cirrhosis and carcinoma of liver due to HBV infection did not emerge as major problems in long-term survivors. Conclusion: Patients infected hepatitis B virus are not a contraindication to HSCT. Neither HBV infection interfered with the engraf-tment of hematopoietic stem cells, nor increased the rate of VOD and GVHD, but they may increase the development of hepatitis and abnormal liver function of the patients. When the patients with HBsAg(+) received HSCT, the damage of liver function was more severe than control group. The measures to protect the damage of liver function should be taken. The administration of prophylac-tic ganciclovir for virus may be effective to prevent the activation of HBV.