Incidence of Hepatitis B Viral Reactivation after Kidney Transplantation with Low-Dose Rituximab Administration

Kosuke Masutani, Kazuya Omoto, Masayoshi Okumi, Yasuhiro Okabe, Tomokazu Shimizu, Kazuhiko Tsuruya, Takanari Kitazono, Masafumi Nakamura, Hideki Ishida, Kazunari Tanabe

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Abstract

Background In hematological malignancy patients intended to receive rituximab, hepatitis B virus (HBV) serology screening, viral reactivation monitoring, are recommended. However, the effect of single-dose rituximab (RIT) on HBV reactivation in kidney transplant patients with previous HBV infection is still unclear. Methods In this retrospective cohort study consisting of 1294 kidney transplant patients, we identified 76 patients showing preoperative hepatitis B surface antigen-negative, hepatitis B core antibody-positive, and HBV-DNA-negative results. A rituximab dose of 200 mg/body was administered to 48 patients, 46 of whom did not receive prophylaxis (RIT+ group). Twenty-eight patients received neither rituximab nor prophylaxis (RIT- group). We monitored HBV-DNA by polymerase chain reaction every 1 to 3 months, and HBV reactivation was defined as detectable HBV-DNA. Results HBV reactivation was found in 1 patient in the RIT+ group (2.2%) and 1 patient in the RIT- group (3.6%) at 6 weeks and 5.5 years posttransplant, respectively, but spontaneously cleared. Both patients showed positive hepatitis B surface antibody preoperatively. HBV reactivation was not found in 6 patients lacking anti-hepatitis B surface preoperatively. Conclusions Low-dose RIT administration in kidney transplant patients without prophylaxis is associated with low incidence of HBV reactivation. However, the comparisons among standard-dose RIT, low-dose RIT, and controls with high-quality study design is necessary.

Original languageEnglish
Pages (from-to)140-145
Number of pages6
JournalTransplantation
Volume102
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Hepatitis B
Kidney Transplantation
Hepatitis B virus
Incidence
Hepatitis B Antibodies
Transplants
Kidney
Rituximab
DNA
Virus Diseases
Hematologic Neoplasms
Serology
DNA-Directed DNA Polymerase
Hepatitis B Surface Antigens
Cohort Studies
Retrospective Studies
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Transplantation

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Incidence of Hepatitis B Viral Reactivation after Kidney Transplantation with Low-Dose Rituximab Administration. / Masutani, Kosuke; Omoto, Kazuya; Okumi, Masayoshi; Okabe, Yasuhiro; Shimizu, Tomokazu; Tsuruya, Kazuhiko; Kitazono, Takanari; Nakamura, Masafumi; Ishida, Hideki; Tanabe, Kazunari.

In: Transplantation, Vol. 102, No. 1, 01.01.2018, p. 140-145.

Research output: Contribution to journalArticle

Masutani, Kosuke ; Omoto, Kazuya ; Okumi, Masayoshi ; Okabe, Yasuhiro ; Shimizu, Tomokazu ; Tsuruya, Kazuhiko ; Kitazono, Takanari ; Nakamura, Masafumi ; Ishida, Hideki ; Tanabe, Kazunari. / Incidence of Hepatitis B Viral Reactivation after Kidney Transplantation with Low-Dose Rituximab Administration. In: Transplantation. 2018 ; Vol. 102, No. 1. pp. 140-145.
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