Hepatitis B screening before rituximab therapy: a multicentre South Australian study of adherence

Hall, Samuel; Shaikh, A. Obaid S.; Teh, Kailin; Tantiongco, M.; Coghlan, D.; Karapetis, Christos S.; Chinnaratha, Mohamed Asif; Woodman, Richard; Muller, Kate; Wigg, Alan

doi:10.1111/imj.13740

Cited by 9 publications

(15 citation statements)

References 10 publications

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“…Adherence was assessed by documentation of both HBsAg and HBcAb prior to rituximab initiation. Two hundred and nine (47.7%) failed to receive appropriate HBV screening, 86 (19.6%) had neither HBsAg nor HBcAb performed, and 119 (27.2%) had only HBsAg performed [8]. These results are consistent with our observations, showing that insufficient HBV screening in lymphoma patients is a global problem requiring probably generalized educational efforts in the oncohematologic community.…”

Section: Discussionsupporting

confidence: 89%

Hepatitis B virus screening in patients with non-Hodgkin lymphoma in clinical practice in Poland – a report of the Polish Lymphoma Research Group

Kalinka

Drozd‐Sokołowska

Waszczuk‐Gajda

et al. 2020

aoms

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Introduction: The risk of HBV reactivation is important in lymphoma patients receiving immunosuppressive chemotherapy containing steroids or anti-CD20 antibodies. We aimed to establish the prevalence of HBV Ag and anti-HBc serologic positive results in patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) in Poland before anti-CD20 therapy initiation; to assess the frequency of insufficient HBV screening; and to assess the association between inadequate HBV screening and diagnosis according to the WHO classification and age or gender. Material and methods: We retrospectively collected data from 805 patients with non-Hodgkin lymphoma and chronic lymphocytic leukemia treated in 2016-2018. Results: We found a positive result of HBsAg in 13 (1.16%), and a negative result in 633 (78.64%) patients. The test was not done in 159 (19.75%) patients. In the HBsAg negative subgroup of 633 patients, we found that the anti-HBc was positive in 52 (8.22%), negative in 303 (47.87%) and not done in 278 patients. In 136 out of 805 (16.9%) patients diagnostics tests were not performed before therapy initiation. We found that age is significantly associated (p = 0.0002) with the lack of HBV infection screening, and in CLL this risk is significantly (p = 0.024) higher (by 49%) compared with other WHO diagnosis subgroups. Conclusions: In Polish lymphoma patients the incidence of positive HBsAg and/or anti-HBc results is consistent with the prevalence in the United States or Australia. The adherence to appropriate HBV screening guidelines in Polish centers is not sufficient. We should intensify educational strategies in the global oncohematologic medical community.

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Section: Discussionsupporting

confidence: 89%

Hepatitis B virus screening in patients with non-Hodgkin lymphoma in clinical practice in Poland – a report of the Polish Lymphoma Research Group

Kalinka

Drozd‐Sokołowska

Waszczuk‐Gajda

et al. 2020

aoms

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“…Furthermore, COPD was the only clinical factor that significantly affected a patient's likelihood of receiving a β-blocker at discharge. 16,28 Whilst COPD was the only significant predictor of not receiving a β-blocker on discharge in our analysis, there are likely other factors that influence the use of β-blockers. [7][8][9] This is in keeping with results of previous studies, which have postulated that the reduced level of prescribing is due to fear of inducing bronchospasm and worsening COPD.…”

Section: Discussionmentioning

confidence: 96%

“…[7][8][9] This is in keeping with results of previous studies, which have postulated that the reduced level of prescribing is due to fear of inducing bronchospasm and worsening COPD. 16,28 Whilst COPD was the only significant predictor of not receiving a β-blocker on discharge in our analysis, there are likely other factors that influence the use of β-blockers.…”

Section: Discussionmentioning

confidence: 96%

Under‐utilisation of β‐blockers in patients with acute coronary syndrome and comorbid chronic obstructive pulmonary disease

Kratzer

Noakes

Baumwol

et al. 2018

Internal Medicine Journal

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“…Patients who are previously exposed to HBV (hepatitis B core antibody [anti‐HBc] positive and hepatitis B surface antigen [HBsAg] negative) or currently infected (HBsAg positive) should be monitored and/or treated with anti‐viral prophylaxis according to their risk profile that is based on their serologic status and the specific immunosuppressive/biologic agent used 83 . While the screening rate for HBV in this population is reported to be about 70% in Japan or almost 90% with an electronic alert system at a hospital in Spain, 84,85 it was only 20%‐50% in patients receiving rituximab in the United Kingdom (UK) and Australia, 86,87 43% among US Veterans Administration inflammatory bowel disease patients receiving anti‐TNF medications 88 and only 17% among patients receiving parenteral chemotherapy at a major US hospital network (2012‐2015) 89 . In another study evaluating 3051 cancer patients from both academic and community practices in the US, 42% of patients found to have CHB via screening was not aware of their HBV infection 90 .…”

Section: Gaps In Screening Diagnosis and Connection To Care For Infementioning

confidence: 99%

Review article: current gaps and opportunities in HBV prevention, testing and linkage to care in the United States—a call for action

Yeo

Nguyen

2020

Aliment Pharmacol Ther

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SummaryBackgroundThe World Health Organization (WHO) has set an elimination goal for hepatitis B virus (HBV) by 2030, so a comprehensive review of current HBV testing and care gaps are needed to help formulate solutions and opportunities for action.AimsTo summarise current gaps and barriers, and to propose solutions for HBV prevention, testing and linkage to care in the United StatesMethodsRelevant guidelines and studies were reviewed including a systematic review of HCC surveillance adherence.ResultsA total of 64.5 million (95% CI, 61.3‐67.5) high‐risk US adults had no evidence of HBV immunity. Only 18.6% (95% CI, 13.5‐29.9) of privately insured patients with HBV infection have been diagnosed. Among those with known HBV infection, linkage to care rate (33.3%‐57%) was poor and the adherence to guidelines regarding anti‐viral therapy (30.66% [95% CI, 30.28‐31.03]) and HCC surveillance (8%‐87%, from a systematic review) were poor with even more concerning data for care and treatment retention. The causes are complex and include lack of access to medical care, lack of physician knowledge, lack of patient health literacy and awareness, linguistic and cultural barriers and fear of stigma.ConclusionsA ‘scale‐up’ effort is needed to optimise the care continuum to achieve the WHO 2030 targets. As targeted screening policy has leftover 80% of patients undiagnosed, we advocate for universal screening which can help to remove barriers regarding stigma. More active and system level interventions are also needed to improve linkage to care for patients with HBV infection.

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Hepatitis B screening before rituximab therapy: a multicentre South Australian study of adherence

Cited by 9 publications

References 10 publications

Hepatitis B virus screening in patients with non-Hodgkin lymphoma in clinical practice in Poland – a report of the Polish Lymphoma Research Group

Hepatitis B virus screening in patients with non-Hodgkin lymphoma in clinical practice in Poland – a report of the Polish Lymphoma Research Group

Under‐utilisation of β‐blockers in patients with acute coronary syndrome and comorbid chronic obstructive pulmonary disease

Review article: current gaps and opportunities in HBV prevention, testing and linkage to care in the United States—a call for action

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