ArticleHematology, transfusion and cell therapy2026
Hepatitis B virus reactivation risk in haploidentical versus matched donor transplantation: Impact of universal prophylaxis.
Article in Hematology, transfusion and cell therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatitis B virus reactivation is a serious complication of allogeneic hematopoietic cell transplantation, particularly in endemic regions. Patients with HBsAg-negative/anti-HBc-positive serology represent an intermediate-risk group due to occult hepatitis B virus infection. This study evaluated hepatitis B virus reactivation risk in haploidentical versus matched donor hematopoietic cell transplantation and assessed the effectiveness of Taiwan's universal prophylaxis policy.
methodsA retrospective cohort study of 165 adult hematopoietic cell transplantation recipients with HBsAg-negative/anti-HBc-positive status was conducted at China Medical University Hospital, Taiwan from 2010-2025. The incidence of hepatitis B virus reactivation was compared between the pre-prophylaxis (2010-February 2021) and post-policy implementation (March 2021-2025) periods. Univariable associations, clinical outcomes, and temporal patterns were analyzed.
resultsPre-prophylaxis, haploidentical recipients had higher reactivation rates (11.2%vs. 2.9%), but this did not reach statistical significance due to the small number of events (Odds ratio: 4.31; 95% CI: 0.67-37.55; p = 0.279). In the univariable analyses, hepatitis B virus reactivation was associated with chronic graft-versus-host disease (p = 0.001) and donor anti-HBs negativity (p = 0.001), with a median time to reactivation of 8.2 months.
conclusionIn this cohort, haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide was associated with a higher observed rate of hepatitis B virus reactivation than matched donor transplantation in HBsAg-negative/anti-HBc-positive recipients, although this difference was not statistically significant.
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