Abstract：
BACKGROUND: Hepatitis B virus reactivation (HBVr) can occur in solid organ transplant (SOT) recipients with previously inactive hepatitis B virus (HBV) infection. Previous studies have reported that HBVr is generally less than 10% in nonliver SOT recipients with past HBV infection.
METHODS: We conducted a retrospective study from January 2018 to August 2023 at Mayo Clinic sites in Arizona, Florida, and Minnesota. We examined the antiviral prophylaxis strategy used and the characteristics of HBVr in hepatitis B core antibody-positive (HBcAb +) nonliver SOT adult recipients. Past HBV infection was defined as HBcAb + / hepatitis B surface antigen (HBsAg) -. Chronic HBV infection was defined as HBcAb + / HBsAg +.
RESULTS: A total of 180 nonliver SOT recipients were identified during the study period. Indefinite antiviral prophylaxis was utilized in 77 recipients, and none developed HBVr after transplantation. In 103 recipients without antiviral prophylaxis, the incidence of HBVr was 12% (12/97) and 33% (2/6) in those with past HBV infection and chronic HBV infection. The incidence of HBVr in patients with past HBV infection is 16% (8/50), 15% (3/20), and 5% (1/22) in kidney, heart, and lungs, respectively. HBVr was more frequent in those who received alemtuzumab. Among 14 recipients with HBVr, none had HBV-associated liver failure or death.
CONCLUSIONS: Our study observed a higher rate of HBVr (12%) in nonliver SOT recipients with past HBV infection compared to the previous studies. Further studies are needed to identify predictors of HBVr in nonliver SOT recipients and optimize antiviral prophylaxis guidance.
METHODS: We conducted a retrospective study from January 2018 to August 2023 at Mayo Clinic sites in Arizona, Florida, and Minnesota. We examined the antiviral prophylaxis strategy used and the characteristics of HBVr in hepatitis B core antibody-positive (HBcAb +) nonliver SOT adult recipients. Past HBV infection was defined as HBcAb + / hepatitis B surface antigen (HBsAg) -. Chronic HBV infection was defined as HBcAb + / HBsAg +.
RESULTS: A total of 180 nonliver SOT recipients were identified during the study period. Indefinite antiviral prophylaxis was utilized in 77 recipients, and none developed HBVr after transplantation. In 103 recipients without antiviral prophylaxis, the incidence of HBVr was 12% (12/97) and 33% (2/6) in those with past HBV infection and chronic HBV infection. The incidence of HBVr in patients with past HBV infection is 16% (8/50), 15% (3/20), and 5% (1/22) in kidney, heart, and lungs, respectively. HBVr was more frequent in those who received alemtuzumab. Among 14 recipients with HBVr, none had HBV-associated liver failure or death.
CONCLUSIONS: Our study observed a higher rate of HBVr (12%) in nonliver SOT recipients with past HBV infection compared to the previous studies. Further studies are needed to identify predictors of HBVr in nonliver SOT recipients and optimize antiviral prophylaxis guidance.
摘要：
背景：乙型肝炎病毒再激活（HBVr）可以发生在实体器官移植（SOT）受者与以前无效的乙型肝炎病毒（HBV）感染。以前的研究报道，HBVr在过去的HBV感染的非肝脏SOT受体中通常低于10％。
方法：我们从2018年1月至2023年8月在亚利桑那州的梅奥诊所进行了一项回顾性研究，佛罗里达,明尼苏达州。我们检查了使用的抗病毒预防策略和乙型肝炎核心抗体阳性（HBcAb）非肝SOT成人接受者的HBVr特征。过去的HBV感染定义为HBcAb+/乙型肝炎表面抗原（HBsAg）-。慢性HBV感染定义为HBcAb+/HBsAg+。
结果：在研究期间确定了180名非肝脏SOT接受者。77名接受者使用了无限期抗病毒预防，移植后未出现HBVr。在103个没有抗病毒预防的接受者中，既往HBV感染和慢性HBV感染患者的HBVr发生率分别为12%(12/97)和33%(2/6).过去HBV感染患者的HBVr发生率为16％（8/50），15%（3/20），和5%（1/22）在肾脏，心,和肺，分别。在接受阿仑单抗的患者中，HBVr更为频繁。在14名HBVr接受者中，无HBV相关性肝衰竭或死亡。
结论：我们的研究观察到，与以前的研究相比，过去HBV感染的非肝脏SOT受体的HBVr（12％）发生率更高。需要进一步的研究来确定非肝脏SOT受体中HBVr的预测因子并优化抗病毒预防指导。
方法：我们从2018年1月至2023年8月在亚利桑那州的梅奥诊所进行了一项回顾性研究，佛罗里达,明尼苏达州。我们检查了使用的抗病毒预防策略和乙型肝炎核心抗体阳性（HBcAb）非肝SOT成人接受者的HBVr特征。过去的HBV感染定义为HBcAb+/乙型肝炎表面抗原（HBsAg）-。慢性HBV感染定义为HBcAb+/HBsAg+。
结果：在研究期间确定了180名非肝脏SOT接受者。77名接受者使用了无限期抗病毒预防，移植后未出现HBVr。在103个没有抗病毒预防的接受者中，既往HBV感染和慢性HBV感染患者的HBVr发生率分别为12%(12/97)和33%(2/6).过去HBV感染患者的HBVr发生率为16％（8/50），15%（3/20），和5%（1/22）在肾脏，心,和肺，分别。在接受阿仑单抗的患者中，HBVr更为频繁。在14名HBVr接受者中，无HBV相关性肝衰竭或死亡。
结论：我们的研究观察到，与以前的研究相比，过去HBV感染的非肝脏SOT受体的HBVr（12％）发生率更高。需要进一步的研究来确定非肝脏SOT受体中HBVr的预测因子并优化抗病毒预防指导。
