Hepatitis B virus vaccination of recipients and donors of allogeneic peripheral blood stem cell transplantation

Background: The aim of this study was to determine the role of hepatitis B virus (HBV) vaccination as defined by the seroconversion to hepatitis B surface antibody (anti-HBs) positivity in peripheral blood stem cell transplants. Methods: A total of 65 recipients and their donors were enrolled in this study. Recipients were divided into four distinct groups. Group 1 consisted of individuals who were vaccinated, group 2 consisted of individuals who were naturally immunized, group 3 consisted of individuals who were HBs-Ag positive, and group 4 consisted of individuals who were HBV naive and not vaccinated. Results: Eighty-eight percent of the HBV-vaccinated recipients (14 of 16), who had vaccinated-donors, seroconverted to anti-HBs positivity. Eighty-three percent of HBV-naive recipients (five of six), who received stem cells from HBV-immune donors, seroconverted to anti-HBs positivity. Two of the four HBs-Ag positive recipients with HBV-immune donors seroconverted to anti-HBs positivity after transplantation. Fifty-seven percent of previously vaccinated-recipients (eight of 14) lost detectable anti-HBs antibody following transplantation. Finally, 31% of HBV-naive recipients with HBV-naive donors acquired a de novo HBV infection. Conclusions: (i) Hepatitis B virus immunization of recipients of allogeneic hematopoietic cell transplantation results in an effective antibody response. (ii) The HBV-immune status of the donor plays an important role in post-transplantation HBs-Ab on seroconversion. (iii) Systematic re-immunization of recipients will be necessary to maintain HBV immunity in long-term serving recipients.