Passive acquisition of hepatitis B virus antibodies after allogeneic hematopoietic cell transplantation
Takaaki Konuma, Maki Monna‐Oiwa, Etsuko Nagai, Seiko Kato, Shohei Andoh, Junichi Kuroda, Satoshi Takahashi, Yasuhito NannyaAbstract
Background
Newly positive hepatitis B virus (HBV) serologic results after allogeneic hematopoietic cell transplantation (HCT) may reflect passive antibody transfer from blood‐derived products rather than HBV infection. We investigated the incidence and temporal patterns of hepatitis B surface antibody (anti‐HBs) and antibody to hepatitis B core antibody (anti‐HBc) acquisition after allogeneic HCT.
Study Design and Methods
We retrospectively evaluated 193 adults who underwent allogeneic HCT for hematologic diseases between May 2012 and March 2025 at a single institution in Japan. Anti‐HBs, anti‐HBc, and hepatitis B surface antigen (HBsAg) were assessed before and after HCT.
Results
Among 180 patients who were anti‐HBc negative before HCT, 6 (3.3%) developed anti‐HBc positivity after HCT. Among 164 patients who were anti‐HBs negative before HCT, 49 (29.9%) developed anti‐HBs positivity. All patients with newly detectable antibodies remained HBsAg negative, and available HBV DNA measurements showed no evidence of active HBV infection. Among patients with subsequent follow‐up measurements, anti‐HBc disappeared in 3 of 3 evaluable patients after a median of 240 days, whereas anti‐HBs declined or disappeared in 30 of 32 evaluable patients after a median of 119 days. Among patients receiving neither fresh frozen plasma nor intravenous immunoglobulin, anti‐HBs concentrations increased significantly after HCT ( p < .0001), with a greater increase among those receiving ≥24 versus ≤23 platelet transfusions ( p = .0437).
Discussion
Newly detectable HBV antibodies were common after HCT without virologic evidence of infection, suggesting passive antibody transfer from cellular blood components, particularly platelets.