Screening and Prophylaxis to Prevent Hepatitis B Reactivation: Patients with Hematological and Solid Tumor Malignancies

Joe Sasadeusz; Andrew Grigg; Peter D Hughes; Seng Lee Lim; Michaela Lucas; Geoff McColl; Sue Anne McLachlan; Marion G Peters; Nicholas Shackel; Monica Slavin; Vijaya Sundararajan; Alexander Thompson; Joseph Doyle; James Rickard; Peter De Cruz; Robert G Gish; Kumar Visvanathan

doi:10.1016/j.cld.2019.04.011

Screening and Prophylaxis to Prevent Hepatitis B Reactivation: Patients with Hematological and Solid Tumor Malignancies

Clin Liver Dis. 2019 Aug;23(3):511-519. doi: 10.1016/j.cld.2019.04.011. Epub 2019 Jun 6.

Authors

Joe Sasadeusz¹, Andrew Grigg², Peter D Hughes³, Seng Lee Lim⁴, Michaela Lucas⁵, Geoff McColl⁶, Sue Anne McLachlan⁷, Marion G Peters⁸, Nicholas Shackel⁹, Monica Slavin¹⁰, Vijaya Sundararajan¹¹, Alexander Thompson¹², Joseph Doyle¹³, James Rickard², Peter De Cruz¹⁴, Robert G Gish¹⁵, Kumar Visvanathan¹²

Affiliations

¹ Peter Doherty Institute for Infection and Immunity, Elizabeth Street, Melbourne, Victoria 3000, Australia; University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia. Electronic address: j.sasadeusz@mh.org.au.
² Olivia Newton John Cancer Research Institute, Austin Hospital, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
³ University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia.
⁴ National University of Singapore, 21 Lower Kent Ridge Road, Singapore 119077, Singapore.
⁵ University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
⁶ University of Queensland Oral Health Centre, 288 Herston Road, Queensland 4006, Australia.
⁷ St Vincent's Hospital, 41 Victoria Street, Fitzroy, Victoria 3065, Australia.
⁸ University of California, San Francisco, S357 Parnassus Avenue, San Francisco, CA 94143, USA.
⁹ Ingham Institute, 1 Campbell Street, Liverpool, Sydney, North South Wales 2170, Australia.
¹⁰ Royal Melbourne Hospital, 300 Grattan Street, Parkville, Victoria 3050, Australia; Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3000, Australia.
¹¹ University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; St Vincent's Hospital, 41 Victoria Street, Fitzroy, Victoria 3065, Australia; Department of Public Health, La Trobe University, Plenty Road, Bundoora, Victoria 3086, Australia.
¹² University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; St Vincent's Hospital, 41 Victoria Street, Fitzroy, Victoria 3065, Australia.
¹³ The Alfred and Monash University, 85 Commercial Road, Melbourne, Victoria 3004, Australia; Burnet Institute, 85 Commercial Road, Melbourne, Victoria 3004, Australia.
¹⁴ University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia.
¹⁵ Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA.

PMID: 31266624
DOI: 10.1016/j.cld.2019.04.011

Abstract

Patients with malignancies require chemotherapy and other immunosuppressive therapies for treatment. Because of this immunosuppression, in patients who have ever been exposed to hepatitis B it is possible for reactivation to occur. This reactivation can be fatal. Reactivation is particularly likely in patients who receive B cell-active agents such as rituximab. The occurrence of reactivation flares may also delay further chemotherapy, which can negatively affect the outcome of the underlying malignancy. Accordingly, it is important to screen patients for markers of hepatitis B and institute antiviral prophylaxis to prevent reactivation.

Keywords: Cancer; Hematological malignancy; Hepatitis B; Prophylaxis; Reactivation; Rituximab; Solid tumors.

Publication types

Review

MeSH terms

Cause of Death
Female
Hematologic Neoplasms / epidemiology*
Hematologic Neoplasms / immunology
Hepatitis B Antibodies / immunology
Hepatitis B virus / physiology*
Hepatitis B, Chronic / epidemiology
Hepatitis B, Chronic / physiopathology
Hepatitis B, Chronic / prevention & control*
Humans
Immunocompromised Host*
Male
Mass Screening
Neoplasms / epidemiology*
Neoplasms / immunology
Prevalence
Primary Prevention / methods
Prognosis
Risk Assessment
Survival Analysis
Virus Activation / drug effects
Virus Activation / immunology*

Substances

Hepatitis B Antibodies