The effect of anticancer therapy on anti-hepatitis B antibody titres in patients with haematological malignancies and solid tumours

J Int Med Res. 2016 Jun;44(3):627-38. doi: 10.1177/0300060516638992. Epub 2016 Apr 5.

Abstract

Objective: To investigate the effect of immunosuppressive anticancer therapy on titre levels of anti-hepatitis B surface antibodies (anti-HBs) in hepatitis B surface antigen (HBsAg) negative and anti-HBs positive patients with haematological malignancies or solid tumours.

Methods: This retrospective study reviewed the medical records of patients with haematological malignancies or solid tumours. Pretreatment HBsAg negative and anti-HBs positive patients were included in the analysis. Anti-hepatitis B core antibody status was used to evaluate vaccinated patients and those with resolved HBV infections.

Results: The medical records of 237 patients were reviewed retrospectively. The median anti-HBs titre decreased significantly after anticancer therapy compared with the pretreatment median anti-HBs titre in all patients (71 mIU/ml versus 57 mIU/ml). Anti-HBs titre decreased significantly in patients with haematological malignancies (70 mIU/m versus 37 mIU/ml) and in patients administered rituximab-based chemotherapy (67 mIU/ml versus 33 mIU/ml) following chemotherapy, whereas there was no significant change in patients with solid tumours. After chemotherapy, patients with low pretreatment anti-HBs titres (<100 mIU/ml) were more likely to become seronegative (<10 mIU/ml).

Conclusion: High levels of anti-HBs may have a protective effect against the reactivation of HBV especially in patients with haematological malignancies who received immunosuppressive anticancer therapy.

Keywords: Hepatitis B virus reactivation; chemotherapy; haematological malignancy; hepatitis B surface antibody; solid tumour.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use*
  • Biomarkers / metabolism
  • Demography
  • Female
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / drug therapy
  • Hematologic Neoplasms / immunology*
  • Hematologic Neoplasms / virology*
  • Hepatitis B Antibodies / immunology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Hepatitis B Antibodies
  • Immunosuppressive Agents