The efficacy of lamivudine prophylaxis against hepatitis B reactivation in breast cancer patients undergoing chemotherapy: A meta-analysis

Liu, Junying; Sheng, Yun-Jian; Ding, Xiangchun; Tang, Hui; Tong, Shiwen; Zhang, Dazhi; Zhou, Zhi; Hu, Peng; Liao, Yong; Ren, Hong; Hu, Huaidong

doi:10.1016/j.jfma.2012.10.007

Cited by 16 publications

(16 citation statements)

References 58 publications

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“…The acute flare or “reactivation” results from immune reconstitution directed towards the rise in HBV DNA following the use of immunosuppressive or immunomodulating agents . A recent meta‐analysis of clinical trials suggested that treatment with LAM or entecavir may prevent HBV reactivation during chemotherapy . It is recommended that Asian patients be screened for HBsAg prior to initiation of chemotherapy or immunosuppressive therapy.…”

Section: Special Populationsmentioning

confidence: 99%

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An expert consensus for the management of chronic hepatitis B in Asian Americans

Tong

Pan

Han³

et al. 2018

Aliment Pharmacol Ther

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SummaryBackgroundHepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide.AimTo generate recommendations for the management of Asian Americans infected with HBV.MethodsThese guidelines are based on relevant data derived from medical reports on HBV from Asian countries as well as from studies in the HBsAg positive Asian Americans. The guidelines herein differ from other recommendations in the treatment of both HBeAg positive and negative chronic hepatitis B (CHB), in the approach to HCC surveillance, and in the management of HBV in pregnant women.ResultsAsian American patients, HBeAg positive or negative, with HBV DNA levels >2000 IU/mL (>104 copies/mL) and ALT values above normal are candidates for anti‐viral therapy. HBeAg negative patients with HBV DNA >2000 IU/mL and normal ALT levels but who have either serum albumin <3.5 g/dL or platelet count <130 000 mm3, basal core promoter (BCP) mutations, or who have first‐degree relatives with HCC should be offered treatment. Patients with cirrhosis and detectable HBV DNA must receive life‐long anti‐viral therapy. Indications for treatment include pregnant women with high viraemia, coinfected patients, and those requiring immunosuppressive therapy. In HBsAg positive patients with risk factors, life‐long surveillance for HCC with alpha‐fetoprotein (AFP) testing and abdominal ultrasound examination at 6‐month intervals is required. In CHB patients receiving HCC treatments, repeat imaging with contrast CT scan or MRI at 3‐month intervals is strongly recommended. These guidelines have been assigned to a Class (reflecting benefit vs. risk) and a Level (assessing strength or certainty) of evidence.ConclusionsApplication of the recommendations made based on a review of the relevant literature and the opinion of a panel of Asian American physicians with expertise in HBV treatment will inform physicians and improve patient outcomes.

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Section: Special Populationsmentioning

confidence: 99%

“…175 A recent meta-analysis of clinical trials suggested that treatment with LAM or entecavir may prevent HBV reactivation during chemotherapy. 176,177 It is recommended that Asian patients be screened for HBsAg prior to initiation of chemotherapy or immunosuppressive therapy.…”

Section: Hbv Reactivation During Chemotherapy or Immunosuppressive mentioning

confidence: 99%

An expert consensus for the management of chronic hepatitis B in Asian Americans

Tong

Pan

Han³

et al. 2018

Aliment Pharmacol Ther

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“…On the other hand, the prevalence of chronic hepatitis B and C is a real issue. Lamivudine prophylaxis decreases the risk of reactivation of hepatitis B during chemotherapy [ 14 ]. At the present time, no prophylaxis is recommended for hepatitis C patients.…”

Section: Screening For Tropical Conditionsmentioning

confidence: 98%

Geriatric Oncology

Extermann

Hussain²

2015

Tropical Hemato-Oncology

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Relevance to Tropical AreasAt fi rst glance, geriatric oncology might seem to be a problem limited to developed countries. Yet, as progresses have been made in sanitation, nutrition, and infectious disease prevention and treatment, life expectancy has markedly progressed in tropical countries. For example, the life expectancy at birth is now 65 years or more in 174 of 223 countries listed in the World Factbook, including countries such as India, Bangladesh, the Philippines, Indonesia, Brazil, or Egypt [ 1 ]. In fact in 2000, 59 % of the persons aged 65 and older lived in developing countries, and this proportion is projected to rise to 71 % by 2030 [ 2 ]. With this demographic trend comes an increased prevalence of chronic diseases, cancer being one of them. Therefore, medical teams training and planning for the management of cancer in the elderly will be a crucial component of good cancer care in tropical countries.

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“…The degree of liver dysfunction attributed to HBV reactivation can be asymptomatic, moderate, fulminant or even lead to hepatic failure or mortality potentially . Several studies have shown NAs prophylaxis can decrease hepatitis B flare and the severity of hepatitis attributed to HBV reactivation …”

Section: Introductionmentioning

confidence: 99%

“…According to recent studies, the intervention strategies can be divided into as follows: (i) prophylactic therapy (early pre‐emptive therapy): use of antivirals prior to the start of chemotherapy; (ii) pre‐emptive therapy (deferred pre‐emptive therapy): test HBV DNA regularly and use antivirals immediately when HBV DNA rises above baseline and ALT level is still within normal limits; (iii) therapeutic intervention: use antivirals when ALT level rises . Recent meta‐analyses have addressed the efficacy of pre‐emptive therapy for HBV reactivation in patients with breast cancer . We also performed a meta‐analysis to assess the benefits of prophylactic lamivudine for reactivation by adding more data.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B virus reactivation in breast cancer patients undergoing chemotherapy: A review and meta‐analysis of prophylaxis management

Liu

Jiang

Liang

et al. 2017

Journal of Viral Hepatitis

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Hepatitis B virus (HBV) reactivation during or after chemotherapy in patients with breast cancer has become a remarkable clinical problem. Prophylactic nucleos(t)ide analogues (NAs) are recommended for patients with breast cancer who are hepatitis B surface antigen (HBsAg) positive before chemotherapy. We performed an up-to-date meta-analysis to compare the efficacy of prophylactic lamivudine use with nonprophylaxis in HBsAg-positive breast cancer patients undergoing chemotherapy. PubMed, the Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched for relevant articles until June 2016. Eligible articles comparing the efficacy of prophylactic lamivudine use with nonprophylaxis in HBsAg-positive breast cancer patients undergoing chemotherapy were identified. Eight studies which had enrolled 709 HBsAg-positive breast cancer patients undergoing chemotherapy were analysed. Lamivudine prophylaxis significantly reduced the rates of chemotherapy-associated hepatitis B flares in chronic hepatitis B in breast cancer compared with patients with nonprophylaxis (odds ratio [OR]=0.15, 95% confidence interval [CI]: 0.07-0.35, P<.00001). Chemotherapy disruption rates attributed to HBV reactivation in the prophylaxis groups were significantly lower than the nonprophylaxis groups (OR=0.17, 95% CI: 0.07-0.43, P=.0002). Patients with lamivudine prophylaxis had a higher risk for tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations than patients with nonprophylaxis (OR=6.33, 95% CI: 1.01-39.60, P=.05). Prophylactic antiviral therapy management is necessary for HBsAg-positive breast cancer patients undergoing chemotherapy, in spite of high correlation with lamivudine-resistant HBV variants with YMDD motif mutations.

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The efficacy of lamivudine prophylaxis against hepatitis B reactivation in breast cancer patients undergoing chemotherapy: A meta-analysis

Abstract: Lamivudine prophylaxis in HBsAg seropositive breast cancer patients undergoing chemotherapy is effective in reducing HBV reactivation and HBV-associated morbidity and mortality.

Cited by 16 publications

References 58 publications

An expert consensus for the management of chronic hepatitis B in Asian Americans

An expert consensus for the management of chronic hepatitis B in Asian Americans

Geriatric Oncology

Hepatitis B virus reactivation in breast cancer patients undergoing chemotherapy: A review and meta‐analysis of prophylaxis management

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