Hepatitis B reactivation: diagnosis and management

Huang, Shang‐Chin; Yang, Hung‐Chih; Kao, Jia‐Horng

doi:10.1080/17474124.2020.1774364

Cited by 19 publications

(14 citation statements)

References 125 publications

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“…Conducting HBsAg and HBcAb tests is widely recommended before administering immunosuppressors (37,38). If chronic HBV infection is evident, HBsAb, HBeAg, HBeAb, and HBV DNA may be tested selectively for risk stratification (39). HBsAgpositive tumor patients are suggested to undergo antiviral therapy 1 week before receiving immunosuppressors or are given antivirals and imatinib simultaneously and continue to suppress the risk for HBVr during treatment.…”

Section: Prevention and Treatmentmentioning

confidence: 99%

Hepatitis B Virus Reactivation in Gastrointestinal Stromal Tumor Patients Treated With Imatinib

et al. 2021

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PurposeHepatitis B virus reactivation (HBVr) in patients with gastrointestinal stromal tumors (GISTs) have not been sufficiently characterized. This study aimed to review the possible mechanism of HBVr induced by imatinib and explore appropriate measures for patient management and monitoring.MethodsThe clinical data of GIST patients who experienced HBVr due to treatment with imatinib at Xiangya Hospital (Changsha, Hunan, China) were retrospectively analyzed. A literature review was also conducted.ResultsFive cases were analyzed, including 3 cases in this study. The average age of the patients was 61.8 y, with male preponderance (4 of 5 vs. 1 of 5). These patients received imatinib as adjuvant treatment (n=4) or as neoadjuvant treatment (n=1). Primary tumors were mostly located in the stomach (n=4) or rectum (n=1). High (n=3) or intermediate (n=1) recurrence risk was categorized using the postoperative pathological results (n=4). Imatinib was then started at 400 (n=4) or 200 mg (n=1) daily. Patients first reported abnormal liver function during the 2th (n=1),6th (n=3), or 10th (n=1) month of treatment with imatinib. Some patients (n=4) discontinued imatinib following HBVr; notably, 1 month after discontinuation, 1 patient experienced HBVr. Antivirals (entecavir n=4, tenofovir n=1), artificial extracorporeal liver support (n=1), and liver transplant (n=1) were effective approaches to treating HBVr. Most patients (n=3) showed favorable progress, 1 patient underwent treatment, and 1 patient died due to severe liver failure induced by HBVr.ConclusionsAlthough HBVr is a rare complication (6.12%), HBV screening should be conducted before starting treatment with imatinib in GIST patients. Prophylactic therapy for hepatitis B surface antigen positive patients, prompt antiviral treatment and cessation of imatinib are also necessary.

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Section: Prevention and Treatmentmentioning

confidence: 99%

Hepatitis B Virus Reactivation in Gastrointestinal Stromal Tumor Patients Treated With Imatinib

et al. 2021

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“…Host immune responses play a critical role in HBV control (14,15). Impaired immunity leads to HBV reactivation, showing active virus replication or immunemediated hepatic injury (16). HBV reactivation can be triggered by cancer chemotherapy (17,18) with an incidence as high as 20-50% in patients who are chronic HBV carriers, and infection has been reported in this setting (19).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of anti-PD-1 inhibitors in Chinese patients with advanced lung cancer and hepatitis B virus infection: a retrospective single-center study

Xu¹,

Zeng²,

Yan³

et al. 2021

Transl Lung Cancer Res

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Background: Programmed death protein (ligand) 1 [PD-(L)1] inhibitors have provided new therapeutic options for advanced lung cancer. However, patients with hepatitis B virus (HBV) infection have been traditionally excluded from most registered trials of this form of treatment.Methods: We performed a retrospective analysis of patients with HBV and advanced lung cancer who received anti-PD-1 immunotherapy from September 2018 to May 2020 in our department. Treatmentrelated hepatotoxicity was evaluated and recorded. Overall response rate and progression free survival were also assessed in the patients using iRECIST.Results: Seventeen patients were evaluated in this analysis. Of these, six (35.3%) experienced hepatic transaminase elevation during immunotherapy. Three of these patients developed Grade 3 hepatic immunerelated adverse events and received systemic corticosteroids, following which aminotransferase levels recovered to normal in all patients and no adverse events were observed in subsequent treatment. No patient experienced HBV reactivation or flare. One patient developed active pulmonary tuberculosis (TB). Other adverse events were mild, well tolerated and short term. The objective response rate (ORR) of the cohort was 62.5%, and the median progression-free survival (PFS) was 3 months.Conclusions: Lung cancer patients can be treated safely with anti-PD-1 inhibitors in the context of HBV infection. Close monitoring for hepatotoxicity and prophylactic antiviral therapy is advised. Further studies on the use of anti-PD-1 inhibitors in HBV-infected patients are needed.

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“…Persistent positive HBsAg may indicate an unstable inactive state in IHCs and could result in a reversal of the inactive state or promote progression to end-stage liver disease. Moreover, HBV can be easily reactivated by immunosuppression, leading to varying degrees of liver damage from mild inflammation to liver failure [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Efficacy and Safety of PEGylated Interferon-α2b Treatment in Inactive Hepatitis B Surface Antigen Carriers

Huang

Liao

et al. 2021

Infect Dis Ther

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Introduction: Hepatitis B virus (HBV) infection is associated with the onset of several major liver diseases. Inactive hepatitis B surface antigen (HBsAg) carriers (IHCs) may be successfully treated with PEGylated interferon-a2b (PEG-IFNa2b)-based antiviral therapy; however, studies on this treatment have been insufficient. In this study, we evaluated the efficacy and safety of PEG-IFNa2b treatment in IHCs. Methods: Nineteen IHCs were treated with subcutaneous PEG-IFNa2b (180 lg/week) for 48 weeks (treatment group). Patients were followed up for 24 weeks after treatment

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Hepatitis B reactivation: diagnosis and management

Cited by 19 publications

References 125 publications

Hepatitis B Virus Reactivation in Gastrointestinal Stromal Tumor Patients Treated With Imatinib

Hepatitis B Virus Reactivation in Gastrointestinal Stromal Tumor Patients Treated With Imatinib

Safety and efficacy of anti-PD-1 inhibitors in Chinese patients with advanced lung cancer and hepatitis B virus infection: a retrospective single-center study

Analysis of the Efficacy and Safety of PEGylated Interferon-α2b Treatment in Inactive Hepatitis B Surface Antigen Carriers

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