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专栏:儿科精准医疗

造血干细胞移植术后儿童乙型肝炎病毒感染风险及疫苗保护效果的研究进展

  • 邓鹏飞 ,
  • 张瑞 ,
  • 杨天 ,
  • 费怡
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  • 上海市浦东新区疾病预防控制中心,上海市浦东新区卫生健康监督所,上海 200136
邓鹏飞,男,主治医师,研究方向:接种管理与免疫相关疾病监测及处置;张瑞,女,医师,研究方向:接种管理与免疫相关疾病监测及处置

收稿日期: 2025-09-19

  修回日期: 2025-11-20

  录用日期: 2026-03-18

  网络出版日期: 2026-04-21

基金资助

浦东新区卫生健康委员会面上项目(PW2024A-28);浦东新区卫生健康委员会重点学科(PWZxk2022-25);上海市加强公共卫生体系建设三年行动计划(2023—2025年)优秀学科带头人(GWVI-11.2-XD08);浦东疾控(卫监)科技项目(PDCDC-KJ-2025-13)

Study on the Incidence Risk of Hepatitis B Virus Infection and Vaccine Protection Efficacy in Children After Hematopoietic Stem Cell Transplantation

  • fei Peng Deng ,
  • Rui Zhang ,
  • Tian Yang ,
  • Yi Fei
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  • Shanghai Pudong New Area Center for Disease Control and Prevention Shanghai Pudong New Area Health
    Supervision Institute Shanghai 200136, China

Received date: 2025-09-19

  Revised date: 2025-11-20

  Accepted date: 2026-03-18

  Online published: 2026-04-21

摘要

造血干细胞移植(hematopoietic stem cell transplantationHSCT)术后儿童因受原发性疾病和免疫抑制治疗等多种因素的共同影响,其免疫功能显著受损,导致感染乙型肝炎病毒(hepatitis B virusHBV)的风险大幅增加。HBV的再激活率可达10%~20%,部分儿童甚至可能出现急性肝功能衰竭或移植失败的情况。乙型病毒性肝炎(以下简称乙肝)疫苗是目前预防HBV感染最有效的手段。近年来,随着社会关注度的不断提升,关于HSCT术后儿童这一特殊群体的HBV感染风险、疫苗免疫效果及其安全性方面的研究逐渐增多,然而不同研究间结果存在较大异质性。本研究通过系统检索PubMedCNKI等数据库中20142025年间发表的相关文献资料,旨在全面梳理HSCT术后儿童HBV感染的现状、感染风险及其发病机制,总结该人群接种乙肝疫苗后的免疫效果、安全性以及影响因素,为我国HSCT术后儿童的精准诊疗和乙肝疫苗免疫策略的优化提供科学依据。

 

本文引用格式

邓鹏飞 , 张瑞 , 杨天 , 费怡 .

造血干细胞移植术后儿童乙型肝炎病毒感染风险及疫苗保护效果的研究进展

[J]. 中国医药导刊, 2026 , 28(3) : 256 -261 . DOI: 10.1009-0959.2026.040002

Abstract

Children following hematopoietic stem cell transplantation HSCT experience significantly impaired immune function due to the combined effects of their underlying disease and immunosuppressive therapy which substantially increases their risk of hepatitis B virus HBV infection. The rate of HBV reactivation can reach 10% to 20% with some children potentially developing acute liver failure or experiencing transplant failure. The hepatitis B vaccine remains the most scientifically sound and effective means of preventing HBV infection. In recent years growing societal attention has led to a growing body of research on HBV infection risk vaccine efficacy and safety in this specific population of post-HSCT children. However substantial heterogeneity exists among the findings of different studies. This study systematically retrieves relevant literature published between 2014 and 2025 from authoritative databases such as PubMed and CNKI to comprehensively review the epidemiological status infection risks and pathogenesis of HBV infection in post-HSCT children summarize the immunogenicity safety and influencing factors of hepatitis B vaccination in this population and provide a scientific reference for precision diagnosis and treatment as well as optimization of hepatitis B vaccination strategies for pediatric HSCT recipients in China.


参考文献

    [1 Harada K Kanda J Hirayama M et al. Comparison of nonrelapse mortality after haploidentical hematopoietic stem cell transplantation with post-transplant cyclophosphamide versus single umbilical cord blood transplantation in hematologic diseaseJ.Biol Blood Marrow Tr 2025312):103.

         2  Shen Y Lu H Lin J et al. Haploidentical hematopoietic cell transplantation combined with umbilical cord blood vs. haploidentical hematopoietic cell transplantation in T-cell acute lymphoblastic leukemia patients a multicenter real-world studyJ.Biol Blood Marrow Tr 20253111):930.

         3  Atilla E Atilla PA Toprak SK et al. A review of late complications of allogeneic hematopoietic stem cell transplantationsJ.Clin Transplant 20173110):e13062.

         4  Gentile G Antonelli G. HBV reactivation in patients undergoing hematopoietic stem cell transplantation a narrative reviewJ.Viruses 20191111):1049.

         5  Wu Y Huang H Luo Y. Management of hepatitis b virus in allogeneic hematopoietic stem cell transplantationJ.Front Immunol 2021111):610500.

         6  Yue B Gao Y Hu Y et al. Harnessing CD8+ T cell dynamics in hepatitis B virus-associated liver diseases insights therapies and future directionsJ.Clin Transl Med 2024147):e1731.

         7  Xu LP Lu DP Wu DP et al. Hematopoietic stem cell transplantation activity in China 2020-2021 during the SARS-CoV-2 pandemic a report from the Chinese Blood and Marrow Transplantation Registry GroupJ.Biol Blood Marrow Tr 2023292):131-136.

         8  Passweg JR Baldomero H Ciceri F et al. Hematopoietic cell transplantation and cellular therapies in Europe 2021. the second year of the SARS-CoV-2 pandemic. a report from the EBMT activity surveyJ.Bone Marrow Transpl 2023586):647-658.

         9  Yeung TW Chan W Wong S et al. High infection rates and risk-adapted prevention strategies in contemporary pediatric allogeneic hematopoietic stem cell transplantationJ.Pediatr Discov 202424):e101.

         10 Styczynski J Czyzewski K Wysocki M et al. Increased risk of infections and infection-related mortality in children undergoing haematopoietic stem cell transplantation compared to conventional anticancer therapy a multicentre nationwide studyJ.Clin Microbiol Infect 2016222):171-179.

         11 Liu YC Hsu CM Hsiao SY et al. Hepatitis B virus infection in patients receiving allogeneic hematopoietic stem cell transplantationJ.J Pers Med 20211111):1108.

         12 Zhang A Wu Y Tan Y et al. Determining whether prophylactic antiviral treatment is necessary in HBsAg-negative/HBcAb-positive patients receiving allogeneic hematopoietic stem cell transplantationJ.Biol Blood Marrow Tr 2020265):956-964.

         13 Shan Q Ma X Chen Y et al. Health economic analysis and medical cost analysis of children with severe hepatitis B in China a retrospective study from 2016 to 2022J.Chin Med J Engl), 20241385):562-567.

         14 中国疾病预防控制中心.病毒性传染病-乙型肝炎-流行病学[EB/OL. 2025-05-28)[2025-08-22.https//www.chinacdc.cn/jkyj/mygh02/jbzt/bdxcrb/yxgy/202409/t20240925_300978.html.

         15 尚晋.异基因造血干细胞移植中乙型肝炎过继免疫和抗病毒方案临床研究[D.广州:南方医科大学, 2016.

         16 Bae S K Gushima T Saito N et al. HBV reactivation after hematopoietic stem cell transplantation and rituximab-containing chemotherapy a 12-year experience at a single centerJ.Bone Marrow Transpl 2019544):629-631.

         17 Buzo BF Ramos JF Marques RR et al. Hepatitis B virus among hematopoietic stem cell transplant recipients antiviral impact in seroconversion engraftment and mortality in a Latin American centerJ.Transpl Infect Dis 2020222):e13243.

         18 Nishikawa K Kimura K Kanda Y et al. A prospective trial of vaccine to prevent hepatitis B virus reactivation after hematopoietic stem cell transplantationJ.Bone Marrow Transpl 2020557):1388-1398.

         19 Yu C Sun Y Xu L et al. Hepatitis B seropositive status in recipients or donors is not related to worse outcomes after haploidentical hematopoietic stem cell transplantationJ.Biol Blood Marrow Tr 2021278):661-668.

         20 贲屹然,陈国林.免疫抑制治疗相关的慢性乙型肝炎患者HBV再激活与预防[J.肝脏,2021269):1041-1043.

         21 Gaudeaux P Moirangthem RD Bauquet A et al. T-cell progenitors as a new immunotherapy to bypass hurdles of allogeneic hematopoietic stem cell transplantationJ.Front Immunol 202213956919.

         22 Li X Zhou Q Lu Z et al. Association of HLA-DRB1 alleles with status of antibodies to hepatitis B surface and e antigenJ.J Med Virol 2024968):e29867.

         23 Cai J Chen W Zhang H et al. Revaccination and its efficacy against hepatitis B virus measles mumps and rubella in children after allogeneic hematopoietic stem cell transplantationJ.Chin Med J Engl), 20251385):604-606.

         24 Silva-Pinto A Abreu I Martins A et al. Vaccination after haematopoietic stem cell transplant a review of the literature and proposed vaccination protocolJ.Vaccines Basel), 20241212):1449.

         25 Rubin LG Levin MJ Ljungman P et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised hostJ.Clin Infect Dis 2014583):309-318.

         26 Cordonnier C Einarsdottir S Cesaro S et al. Vaccination of haemopoietic stem cell transplant recipients guidelines of the 2017 European Conference on Infections in Leukaemia ECIL 7)[J.Lancet Infect Dis 2019196):e200-e212.

         27 Chaichotjinda K Anurathapan U Boonsathorn S et al. Immune responses to hepatitis B vaccination after hematopoietic stem cell transplantation in pediatric and young adult patientsJ.Clin Transplant 20203410):e14024.

         28 Conrad A Perry M Langlois ME et al. Efficacy and safety of revaccination against tetanus diphtheria haemophilus influenzae type b and hepatitis B virus in a prospective cohort of adult recipients of allogeneic hematopoietic stem cell transplantationJ.Biol Blood Marrow Tr 2020269):1729-1737.

         29 Zama D Pedretti L Capoferri G et al. Immunization strategies in pediatric patients receiving hematopoietic cell transplantation HCT and chimeric antigen receptor T-cell CAR-T therapy challenges and insights from a narrative reviewJ.Vaccines Basel), 2025139):932.

         30 Giladi A Cohen M Medaglia C et al. Dissecting cellular crosstalk by sequencing physically interacting cellsJ.Nat Biotechnol 2020385):629-637.

         31 Haynes AS Curtis DJ Campbell K et al. An immune recovery-based revaccination protocol for pediatric hematopoietic stem cell transplant recipients revaccination outcomes following pediatric HSCTJ.Biol Blood Marrow Tr 2021274):317-326.

         32 Deng P Yang T Zhang H et al. Prospective clinical trial of hepatitis B vaccination for children with hematological malignancies a study on the safety and immunogenicity efficacyJ.Hum Vaccin Immunother 20211711):4578-4586.

         33 中华医学会血液学分会造血干细胞应用学组. 异基因造血干细胞移植后防治乙型肝炎病毒再激活中国专家共识(2023年版)[R.中华血液学杂志,2023446):441-448.

         34 袁晴,周芬,张桦,等.化疗和(或)造血干细胞移植后儿童乙型病毒性肝炎疫苗再接种有效性及安全性研究[J.中华儿科杂志, 20205810):802-806.

         35 Bae K Choi J Jang Y et al. Innovative vaccine production technologies the evolution and value of vaccine production technologiesJ.Arch Pharm Res 2009324):465-480.

         36 van den Ende C Marano C van Ahee A et al. The immunogenicity of GSK's recombinant hepatitis B vaccine in children a systematic review of 30 years of experienceJ.Expert Rev Vaccines 2017168):789-809.

         37 Carpenter P A Englund J A. Commentary Is immune recovery-based post-transplantation vaccination in children better than time-based revaccination?[J.Biol Blood Marrow Tr 2021274):281-283.

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