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Master Thesis

Evolution of HBs anti-bodies titers ans analysis of risk factors for Loss of seroprotection in patients transplanted from solid organs previously vaccinated against hepatitis B

Abstract : Background: Annual monitoring of the persistence of vaccine-induced protection against hepatitis B virus in solid organ transplanted (SOT) is recommended. However, the longevity of this protection is poorly characterized within this population. Methods: We analysed the data of 321 solid organ transplanted patients, followed up in our centre between 2009 and 2019, negative for anti-HBs antigen and anti-HBc antibody and displayed a pre-transplant anti-HBs antibody (HBsAb) level >10 IU/L (reflecting hepatitis B virus vaccination). We explored the persistence of protective HBsAb titers and the factors associated with the loss of seroprotection (HBsAb <10UI/L). Results: After SOT, during follow-up (median 104 days (interquartile range 92-381)), loss of seroprotection (HBsAbs <10UI/L) was observed in 90/321 (28.0%) patients. In univariate analysis, liver transplantation, age under 50 years and body mass index (BMI) under 30 kg/m2 at time of transplantation, pre-transplantation HBs levels above 100UI/L, induction therapy with antithymocyte globulins, tacrolimus or corticosteroids and maintenance therapy with mycophenolate mofetil or corticosteroids were associated with loss of seroprotection. In multivariate analysis, kidney (HR 0.20 [CI95% 0.12; 0.34]), lung (HR 0.15 [CI95% 0.04; 0.50]) and heart (HR 0.33 [CI95% 0.13; 0.83]) transplantations were associated with delayed loss of seroprotection compared to liver transplantation (p<0.001), similarly, the risk of loss of seroprotection was lower for patients with pre-transplantation HBsAb levels between 100 and 300 IU/L (HR 0.32 [CI95% 0.18-0.60]) or above 300 IU/L (HR 0.10 [CI95% 0.05-0.21]) (p<0.001) compared to levels under 100 IU/L, lastly, patients with BMI under 18 kg/m2 had a higher risk of loss of seroprotection (HR 3.28 [CI95% 1.42-7.61]) than patients with a BMI between 18 and 30 (p=0.01). Conclusion: We identified risk factors of early loss of vaccine protection in vaccinated patients against hepatitis B prior to transplantation. Post-vaccination surveillance should be increased in these populations
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03107519
Contributor : Jean-Hugues Morneau <>
Submitted on : Tuesday, January 12, 2021 - 4:11:23 PM
Last modification on : Friday, January 15, 2021 - 3:18:18 AM
Long-term archiving on: : Tuesday, April 13, 2021 - 6:49:12 PM

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Sophie Lejeune. Evolution of HBs anti-bodies titers ans analysis of risk factors for Loss of seroprotection in patients transplanted from solid organs previously vaccinated against hepatitis B. Human health and pathology. 2020. ⟨dumas-03107519⟩

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