Outcome of nucleos(t)ide analog intervention in patients with preventive or on-demand therapy for hepatitis B virus reactivation.
Adolescent
Adult
Aged
Aged, 80 and over
Antiviral Agents
/ administration & dosage
DNA, Viral
/ blood
Female
Hepatitis B virus
/ drug effects
Hepatitis B, Chronic
/ drug therapy
Humans
Latent Infection
/ drug therapy
Male
Middle Aged
Nucleosides
/ administration & dosage
Recurrence
Retrospective Studies
Symptom Flare Up
Young Adult
HBsAg
anti-HBs
nucleos(t)ide analog
relapse
Journal
Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
24
08
2020
received:
15
07
2020
accepted:
26
08
2020
pubmed:
18
9
2020
medline:
9
10
2021
entrez:
17
9
2020
Statut:
ppublish
Résumé
Preventive or on-demand nucleos(t)ide analog (NA) therapy can prevent severe hepatitis related to hepatitis B virus reactivation (HBV-R). However, it is unclear if NA can be safely stopped in such patients after cytotoxic therapies or during immunosuppressive therapies. We retrospectively evaluated 133 patients who initiated NA therapy between 2007 and 2018. A total of 103 patients were positive for HBV surface antigen (HBsAg) at baseline, and NA therapy was started before cytotoxic or immunosuppressive therapy (preventive group). Thirty patients with resolved HBV infection were treated with NA therapy after HBV reactivation (on-demand group). Virological relapse was defined as a serum HBV DNA level >20 IU/ml. NA therapy was stopped in 12 (12%) patients (preventive group), and in 16 (53%) patients (on-demand group). After the cessation of NA therapy, the cumulative rates of relapse were 36% and 39% at 12 and 24 months, respectively. High levels of HBsAg both at baseline and at the cessation of NA therapy were related to the occurrence of relapse. Relapse did not occur in patients with HBsAg levels <20 IU/ml (preventive group). HBV relapse occurred in five (33%) patients in the on-demand group. Relapse occurred only in anti-HBs-negative patients at the cessation of NA therapy. There were no cases of hepatitis flare after the cessation of NA therapy. HBsAg predicted HBV relapse after the cessation of NA therapy in HBsAg-positive patients. Anti-HBs could be a predictive marker for NA therapy cessation in patients with resolved HBV.
Substances chimiques
Antiviral Agents
0
DNA, Viral
0
Nucleosides
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3679-3687Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Mindikoglu AL, Regev A, Schiff ER. Hepatitis B virus reactivation after cytotoxic chemotherapy: the disease and its prevention. Clin Gastroenterol Hepatol. 2006;4(9):1076-1081.
Loomba R, Liang TJ. Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology. 2017;152(6):1297-1309.
Perrillo RP, Robert Gish, Falck-Ytter YT. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148(1):221-244.
Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599.
WHO https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
Kusumoto S, Tanaka Y, Suzuki R, et al. Ultra-high sensitivity HBsAg assay can diagnose HBV reactivation following rituximab-based therapy in patients with lymphoma. J Hepatol. https://doi.org/10.1016/j.jhep.2020.03.009
Ando R, Asahina Y, Chayama K, et al. JSH Guidelines for the management of hepatitis B virus infection: 2019 update. Hepatol Res. 2020. https://doi.org/10.1111/hepr.13504
Allice T, Cerutti F, Pittaluga F, et al. COBAS AmpliPrep-COBAS TaqMan hepatitis B virus (HBV) test: a novel automated real-time PCR assay for quantification of HBV DNA in plasma. J Clin Microbiol. 2007;45(3):828-834.
Kimura T, Rokuhara A, Sakamoto Y, et al. Sensitive enzyme immunoassay for hepatitis B virus core-related antigens and their correlation to virus load. J Clin Microbiol. 2002;40(2):439-445.
Tanaka E, Matsumoto A. Guidelines for avoiding risks resulting from discontinuation of nucleoside/nucleotide analogs in patients with chronic hepatitis B. Hepatol Res. 2014;44(1):1-8.
Liu J, Li T, Zhang L, Xu A. The role of hepatitis B surface antigen in nucleos(t)ide analogues cessation among Asian patients with chronic hepatitis B: a systematic review. Hepatology. 2019;70(4):1045-1055.
Tseng TN, Hu TH, Wang JH, et al. Incidence and factors associated with HBV relapse after cessation of entecavir or tenofovir in patients with HBsAg below 100 IU/mL. Clin Gastroenterol Hepatol. https://doi.org/10.1016/j.cgh.2020.04.037
Tamori A, Hino M, Kawamura E, et al. Prospective long-term study of hepatitis B virus reactivation in patients with hematologic malignancy. J Gastroenterol Hepatol. 2014;29(9):1715-1721.
Kusumoto S, Tanaka Y, Suzuki R, et al. Monitoring of hepatitis B virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: a prospective observational study. Clin Infect Dis. 2015;61(5):719-729.
Paul S, Dickstein A, Saxena A, et al. Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: a meta-analysis. Hepatology. 2017;66(2):379-388.
Onozawa M, Hashino S, Darmanin S, et al. HB vaccination in the prevention of viral reactivation in allogeneic hematopoietic stem cell transplantation recipients with previous HBV infection. Biol Blood Marrow Transplant. 2008;14(11):1226-1230.
Nishikawa K, Kimura K, Kanda Y, et al. A prospective trial of vaccine to prevent hepatitis B virus reactivation after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2020;55(7):1388-1398.
Westhoff TH, Jochimsen F, Schmittel A, et al. Fatal hepatitis B virus reactivation by an escape mutant following rituximab therapy. Blood. 2003;102(5):1930.
Power JP, El Chaar M, Temple J, et al. HBV reactivation after fludarabine chemotherapy identified on investigation of suspected transfusion-transmitted hepatitis B virus. J Hepatol. 2010;53(4):780-787.