A Case of Acute Exacerbation of Hepatitis B by Pembrolizumab for a Lung Adenocarcinoma Patient with Hepatitis B Surface Antigen

Aoyama, Masahiro; Hayashi, Kazumi; Futamura, Keisuke; Takashima, Koji; Sashio, Toyokazu; Tanikawa, Yoshimasa

doi:10.2482/haigan.60.115

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…As medications that influence HBV reactivation, ICIs have an important role in the management of many types of malignancy. The reports cited in this review 6–14 indicate that CHB or previous infection with HBV is not an obstruction to receiving ICI treatment, although careful observation, including the measurement of HBV DNA, is necessary during and after ICI treatment. Anti‐HBV treatment is recommended if the patient is positive for HBsAg and/or HBV DNA is present at baseline, because if immune‐related adverse events develop after ICI treatment, steroid administration is required immediately.…”

Section: Discussionmentioning

confidence: 92%

“…Several studies of ICI‐treated patients have reported HBV reactivation (Table 4). 6–14 However, these studies had some limitations, including unknown/unspecified HBV markers before treatment, suggesting acute hepatitis cannot be completely ruled out. Other cases suggest HBV reactivation due to steroids administered as a pretreatment of chemotherapy or as an immune‐related adverse event.…”

Section: Medications That Influence Hbv Reactivationmentioning

confidence: 99%

“…The highest risk of HBV reactivation has been reported for anti‐CD20 monoclonal antibody, rituximab, introduced clinically over the past two decades, which results in profound B‐cell depletion 4 . Recently, the occurrence of HBV reactivation was reported among patients treated with immune checkpoint inhibitors (ICIs) and positive for hepatitis B surface antigen (HBsAg) or negative for HBsAg, but positive for hepatitis B core antibody (anti‐HBc) 5–14 …”

Section: Introductionmentioning

confidence: 99%

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Novel strategies for the early diagnosis of hepatitis B virus reactivation

Matsui

Tanaka

2021

Hepatology Research

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Hepatitis B virus (HBV) reactivation under systemic chemotherapy or immunosuppressive therapy is a serious complication among HBV‐resolved patients. Some medications, such as more than 2 weeks of corticosteroid therapy, can influence HBV reactivation; therefore, screening tests that measure hepatitis B surface antigen (HBsAg), hepatitis B core antibody, and hepatitis B surface antibody before therapy are required. Additionally, because HBV reactivation has been reported in patients positive for HBsAg treated with immune checkpoint inhibitors (ICIs), the prophylactic administration of nucleos(t)ide analogues prior to administering ICIs is recommended for HBsAg‐positive patients. Under these circumstances, highly sensitive novel biomarkers are expected to be used for the early diagnosis of HBV reactivation. A fully automated high‐sensitivity HBsAg assay (detection limit: 5 mIU/ml) by Lumipulse HBsAg‐HQ, with 10‐fold higher sensitivity than that of conventional assays, is currently used. Furthermore, ultra‐sensitive HBsAg assays using a semi‐automated immune complex transfer chemiluminescence enzyme immunoassay (ICT‐CLEIA; detection limit: 0.5 mIU/ml) have been developed. Recently, a fully automated, novel high‐sensitivity hepatitis B core‐related antigen assay (iTACT‐HBcrAg; cut‐off value: 2.1 Log U/mL) has been developed and reported. The utility of ICT‐CLEIA and iTACT‐HBcrAg for the diagnosis of HBV reactivation appears comparable to the use of HBV DNA. In this review, we provide the latest information related to medications that influence HBV reactivation and recently developed novel biomarkers that predict and monitor HBV reactivation.

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Section: Discussionmentioning

confidence: 92%

Section: Medications That Influence Hbv Reactivationmentioning

confidence: 99%