Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation

Abstract Sensitized patients received desensitization therapy with rituximab for kidney transplantation. However, the impact of rituximab dose on hepatitis B virus (HBV) reactivation is unknown. Patients who underwent living donor kidney transplantation between 2008 and 2016 were grouped according t...

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Autores principales:	Juhan Lee, Jun Yong Park, Deok Gie Kim, Jee Youn Lee, Beom Seok Kim, Myoung Soo Kim, Soon Il Kim, Yu Seun Kim, Kyu Ha Huh
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Standard Dose Rituximab Hepatitis B Surface Antigen (HBsAg) Hepatitis Flares Rituximab Group Positive Crossmatch Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9a7d958de11d4149ad4bfc4b08b3df1a
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spelling	oai:doaj.org-article:9a7d958de11d4149ad4bfc4b08b3df1a2021-12-02T15:07:58ZEffects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation10.1038/s41598-018-34111-52045-2322https://doaj.org/article/9a7d958de11d4149ad4bfc4b08b3df1a2018-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-34111-5https://doaj.org/toc/2045-2322Abstract Sensitized patients received desensitization therapy with rituximab for kidney transplantation. However, the impact of rituximab dose on hepatitis B virus (HBV) reactivation is unknown. Patients who underwent living donor kidney transplantation between 2008 and 2016 were grouped according to rituximab dose (control vs. standard-dose rituximab [375 mg/m2] vs. reduced-dose rituximab [200 mg/body]) for comparison of HBV reactivation. A total of 336 hepatitis B surface antigen (HBsAg)-negative/antibody to hepatitis B core antigen (anti-HBc)-positive patients underwent kidney transplantation, of whom 91 (27.1%) received rituximab for desensitization (57 standard-dose and 34 reduced-dose rituximab). During the study period, eight patients experienced HBV reactivation (three in the control group, five in the standard-dose group). In the standard-dose group, four patients experienced hepatitis flare, and one patient died due to hepatic failure. No HBV reactivation occurred in the reduced-dose group. Standard-dose rituximab significantly decreased hepatitis B surface antigen antibody titer (anti-HBs; −99.8 IU/L) at 12 months, compared with reduced-dose rituximab (−20.1 IU/L) and control (−39.1 IU/L, P = 0.017). Standard-dose rituximab (HR, 10.60; 95% CI, 2.52–44.60; P = 0.001) and anti-HBs < 100 IU/L at transplantation (HR, 9.06; 95% CI, 1.11–74.30; P = 0.04) were independent risk factors for HBV reactivation. Standard-dose rituximab significantly increased HBV reactivation risk for HBsAg-negative/anti-HBc-positive kidney transplant patients.Juhan LeeJun Yong ParkDeok Gie KimJee Youn LeeBeom Seok KimMyoung Soo KimSoon Il KimYu Seun KimKyu Ha HuhNature PortfolioarticleStandard Dose RituximabHepatitis B Surface Antigen (HBsAg)Hepatitis FlaresRituximab GroupPositive CrossmatchMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-8 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Standard Dose Rituximab Hepatitis B Surface Antigen (HBsAg) Hepatitis Flares Rituximab Group Positive Crossmatch Medicine R Science Q
spellingShingle	Standard Dose Rituximab Hepatitis B Surface Antigen (HBsAg) Hepatitis Flares Rituximab Group Positive Crossmatch Medicine R Science Q Juhan Lee Jun Yong Park Deok Gie Kim Jee Youn Lee Beom Seok Kim Myoung Soo Kim Soon Il Kim Yu Seun Kim Kyu Ha Huh Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
description	Abstract Sensitized patients received desensitization therapy with rituximab for kidney transplantation. However, the impact of rituximab dose on hepatitis B virus (HBV) reactivation is unknown. Patients who underwent living donor kidney transplantation between 2008 and 2016 were grouped according to rituximab dose (control vs. standard-dose rituximab [375 mg/m2] vs. reduced-dose rituximab [200 mg/body]) for comparison of HBV reactivation. A total of 336 hepatitis B surface antigen (HBsAg)-negative/antibody to hepatitis B core antigen (anti-HBc)-positive patients underwent kidney transplantation, of whom 91 (27.1%) received rituximab for desensitization (57 standard-dose and 34 reduced-dose rituximab). During the study period, eight patients experienced HBV reactivation (three in the control group, five in the standard-dose group). In the standard-dose group, four patients experienced hepatitis flare, and one patient died due to hepatic failure. No HBV reactivation occurred in the reduced-dose group. Standard-dose rituximab significantly decreased hepatitis B surface antigen antibody titer (anti-HBs; −99.8 IU/L) at 12 months, compared with reduced-dose rituximab (−20.1 IU/L) and control (−39.1 IU/L, P = 0.017). Standard-dose rituximab (HR, 10.60; 95% CI, 2.52–44.60; P = 0.001) and anti-HBs < 100 IU/L at transplantation (HR, 9.06; 95% CI, 1.11–74.30; P = 0.04) were independent risk factors for HBV reactivation. Standard-dose rituximab significantly increased HBV reactivation risk for HBsAg-negative/anti-HBc-positive kidney transplant patients.
format	article
author	Juhan Lee Jun Yong Park Deok Gie Kim Jee Youn Lee Beom Seok Kim Myoung Soo Kim Soon Il Kim Yu Seun Kim Kyu Ha Huh
author_facet	Juhan Lee Jun Yong Park Deok Gie Kim Jee Youn Lee Beom Seok Kim Myoung Soo Kim Soon Il Kim Yu Seun Kim Kyu Ha Huh
author_sort	Juhan Lee
title	Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
title_short	Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
title_full	Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
title_fullStr	Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
title_full_unstemmed	Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
title_sort	effects of rituximab dose on hepatitis b reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/9a7d958de11d4149ad4bfc4b08b3df1a
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_version_	1718388334219231232

Effects of rituximab dose on hepatitis B reactivation in patients with resolved infection undergoing immunologic incompatible kidney transplantation

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