HBV REACTIVATION RISK 

Br J Cancer. 2013 May 7. doi: 10.1038/bjc.2013.225. [Epub ahead of print]

Hepatitis B virus reactivation risk varies with different chemotherapy regimens commonly used in solid tumours.

Ling WH, Soe PP, Pang AS, Lee SC.

Source

Department of Haematology-Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore.

Abstract

Background:Hepatitis B virus (HBV) reactivation may occur with chemotherapy and has significant morbidity and mortality. The United States Centre for Disease Control and Prevention recommends pre-chemotherapy hepatitis B screening for all cancer patients, while the American Society of Clinical Oncology finds that there is insufficient evidence currently to support such a recommendation. Apart from anthracyclines, HBV reactivation rates from other commonly used chemotherapy regimens in solid tumours are not well described.Methods:We compared HBV reactivation risk in patients receiving several commonly used chemotherapy regimens for solid tumours associated with different immunosuppression risk at a tertiary cancer centre in an HBV endemic region.Results:A total of 1149 patients were identified, including 434, 196, 245 and 274, respectively, who received doxorubicin-based, oxaliplatin- or irinotecan-based, carboplatin/gemcitabine, and capecitabine chemotherapy. HBV screening rate was 39% overall. Thirty out of 448 (7%) screened patients were HBsAg positive and 28 out of 30 received prophylactic antiviral therapy with no reactivation. Three out of 1149 patients overall (0.3%) developed HBV reactivation, all from the unscreened doxorubicin group (3 out of 214, 1.4%). No unscreened patients (0 out of 487) in the other three treatment groups developed reactivation (P<0 .001="" 2013="" 7="" advance="" all="" b="" be="" bjc.2013.225="" cancer="" chemotherapy="" doi:10.1038="" for="" hbv="" hepatitis="" in="" journal="" low-="" may="" moderate-risk="" not="" of="" onclusion:not="" online="" or="" p="" publication="" reactivation.="" regimens="" result="" routine="" screening="" warranted.british="" www.bjcancer.com.="">