High risk of clinical relapse in patients with chronic Hepatitis B virus infection after cessation of prophylactic antiviral therapy for rituximab-containing chemotherapy

Wei Yuan Chang, Yen Cheng Chiu, Fang Wei Chiu, Yao Chun Hsu, Tai Chung Tseng, Pin Nan Cheng, Sheng Shun Yang, Chun Jen Liu, Tung Hung Su, Hung Chih Yang, Chen Hua Liu, Pei Jer Chen, Ding Shinn Chen, Jia Horng Kao

研究成果: Article同行評審

4 引文 斯高帕斯(Scopus)

摘要

Background: Prophylaxis with nucleos(t)ide analogue (NA) is recommended to prevent hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-positive patients receiving rituximab-based B-cell depletion therapy. However, little is known about the risk of clinical relapse after withdrawal of NA. Methods: We retrospectively analyzed 77 noncirrhotic HBsAg carriers with hematological cancer who received rituximab-containing chemotherapy. All of them received either prophylactic entecavir or tenofovir therapy. The risk of clinical relapse and hepatic decompensation after cessation of NA was explored. Results: Clinical relapse and hepatic decompensation developed in 25 (32.5 %) and 11 (14.3 %) of the patients, respectively, and 2 patients died of hepatic decompensation. Most of the hepatic events occurred within 1 year (20 of 25; 80.0%) after stopping NA. A higher pretreatment viral load (≥2000 vs <2000 IU/mL) was associated with increased risks of clinical relapse (hazard ratio, 3.47; 95% confidence interval, 1.56-7.73) and hepatic decompensation (9.91; 2.14-45.92). Of 51 patients with pretreatment viral load <2000 IU/mL, clinical relapse occurred in 10 (19.6 %) and hepatic decompensation in 2 (3.9%). Conclusions: Pretreatment HBV DNA ≥2000 IU/mL is associated with increased risk of liver-related disease after cessation of prophylactic NA therapy in patients who received rituximab-containing chemotherapy.

原文English
頁(從 - 到)1345-1352
頁數8
期刊Journal of Infectious Diseases
222
發行號8
DOIs
出版狀態Published - 2020 十月 15

All Science Journal Classification (ASJC) codes

  • 免疫學和過敏
  • 傳染性疾病

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