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Article: Hepatitis B reactivation in patients with previous Hepatitis B Virus exposure undergoing rituximab-containing chemotherapy for lymphoma: a prospective study

TitleHepatitis B reactivation in patients with previous Hepatitis B Virus exposure undergoing rituximab-containing chemotherapy for lymphoma: a prospective study
Authors
Issue Date2014
PublisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/
Citation
Journal of Clinical Oncology, 2014, v. 32 n. 33, p. 3736-3743 How to Cite?
AbstractPurpose: Patterns of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) –negative, antihepatitis B core antigen antibody (anti-HBc) –positive patients with lymphoma receiving rituximab-containing chemotherapy have not been well described. Patients and Methods: HBsAg-negative, anti-HBc–positive Chinese patients with undetectable serum HBV DNA (< 10 IU/mL), diagnosed with hematologic malignancies and receiving rituximab-containing chemotherapy, were prospectively monitored every 4 weeks for up to 2 years. Entecavir was started when HBV reactivation (defined as detectable HBV DNA) was encountered. Results: Among 260 patients receiving rituximab-containing chemotherapy, 63 patients (24.2%) who were HBsAg negative and anti-HBc positive underwent follow-up for a median of 70 weeks (range, 6 to 104 weeks). The 2-year cumulative rate of HBV reactivation was 41.5%, occurring at a median of 23 weeks (range, 4 to 100 weeks) after rituximab treatment. The median HBV DNA level at reactivation was 43 IU/mL (range, 14 to 920 IU/mL). A baseline undetectable antibody to HBsAg (anti-HBs; < 10 mIU/mL) was the only significant risk factor that was positively associated with HBV reactivation (hazard ratio, 3.51; 95% CI, 1.37 to 8.98; P = .009). Patients with negative baseline anti-HBs, compared with those with positive anti-HBs, had a significantly higher 2-year cumulative rate of HBV reactivation (68.3% v 34.4%; P = .012). At HBV reactivation, all patients had normal ALT, and all patients but one were HBsAg negative. Entecavir successfully controlled HBV reactivation in all patients. Conclusion: A high rate of HBV reactivation was observed in HBsAg-negative, anti-HBc–positive patients undergoing rituximab-containing chemotherapy, with the risk of reactivation significantly higher in anti-HBs–negative patients. Periodic HBV DNA monitoring was an effective strategy in preventing HBV-related complications.
Persistent Identifierhttp://hdl.handle.net/10722/199174
ISSN
2019 Impact Factor: 32.956
2015 SCImago Journal Rankings: 9.204
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorSeto, WK-
dc.contributor.authorChan, TSY-
dc.contributor.authorHwang, YY-
dc.contributor.authorWong, DKH-
dc.contributor.authorFung, J-
dc.contributor.authorLiu, KSH-
dc.contributor.authorSingh, G-
dc.contributor.authorLam, YF-
dc.contributor.authorLie, AKW-
dc.contributor.authorLai, CL-
dc.contributor.authorKwong, YL-
dc.contributor.authorYuen, MF-
dc.date.accessioned2014-07-22T01:05:01Z-
dc.date.available2014-07-22T01:05:01Z-
dc.date.issued2014-
dc.identifier.citationJournal of Clinical Oncology, 2014, v. 32 n. 33, p. 3736-3743-
dc.identifier.issn0732-183X-
dc.identifier.urihttp://hdl.handle.net/10722/199174-
dc.description.abstractPurpose: Patterns of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) –negative, antihepatitis B core antigen antibody (anti-HBc) –positive patients with lymphoma receiving rituximab-containing chemotherapy have not been well described. Patients and Methods: HBsAg-negative, anti-HBc–positive Chinese patients with undetectable serum HBV DNA (< 10 IU/mL), diagnosed with hematologic malignancies and receiving rituximab-containing chemotherapy, were prospectively monitored every 4 weeks for up to 2 years. Entecavir was started when HBV reactivation (defined as detectable HBV DNA) was encountered. Results: Among 260 patients receiving rituximab-containing chemotherapy, 63 patients (24.2%) who were HBsAg negative and anti-HBc positive underwent follow-up for a median of 70 weeks (range, 6 to 104 weeks). The 2-year cumulative rate of HBV reactivation was 41.5%, occurring at a median of 23 weeks (range, 4 to 100 weeks) after rituximab treatment. The median HBV DNA level at reactivation was 43 IU/mL (range, 14 to 920 IU/mL). A baseline undetectable antibody to HBsAg (anti-HBs; < 10 mIU/mL) was the only significant risk factor that was positively associated with HBV reactivation (hazard ratio, 3.51; 95% CI, 1.37 to 8.98; P = .009). Patients with negative baseline anti-HBs, compared with those with positive anti-HBs, had a significantly higher 2-year cumulative rate of HBV reactivation (68.3% v 34.4%; P = .012). At HBV reactivation, all patients had normal ALT, and all patients but one were HBsAg negative. Entecavir successfully controlled HBV reactivation in all patients. Conclusion: A high rate of HBV reactivation was observed in HBsAg-negative, anti-HBc–positive patients undergoing rituximab-containing chemotherapy, with the risk of reactivation significantly higher in anti-HBs–negative patients. Periodic HBV DNA monitoring was an effective strategy in preventing HBV-related complications.-
dc.languageeng-
dc.publisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/-
dc.relation.ispartofJournal of Clinical Oncology-
dc.titleHepatitis B reactivation in patients with previous Hepatitis B Virus exposure undergoing rituximab-containing chemotherapy for lymphoma: a prospective study-
dc.typeArticle-
dc.identifier.emailSeto, WK: wkseto2@hku.hk-
dc.identifier.emailHwang, YY: yyhwang@hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailFung, J: jfung@hkucc.hku.hk-
dc.identifier.emailSingh, G: gillhsh@hku.hk-
dc.identifier.emailLam, YF: fyflam@hku.hk-
dc.identifier.emailLie, AKW: akwlie@hkucc.hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hku.hk-
dc.identifier.emailKwong, YL: ylkwong@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityFung, J=rp00518-
dc.identifier.authoritySingh, G=rp01914-
dc.identifier.authorityLam, YF=rp02564-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityKwong, YL=rp00358-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1200/JCO.2014.56.7081-
dc.identifier.pmid25287829-
dc.identifier.scopuseid_2-s2.0-84911424291-
dc.identifier.hkuros231840-
dc.identifier.volume32-
dc.identifier.issue33-
dc.identifier.spage3736-
dc.identifier.epage3743-
dc.identifier.isiWOS:000344861400009-
dc.publisher.placeUnited States-
dc.identifier.issnl0732-183X-

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