Hepatitis B Screening Urged for Patients Undergoing Chemo, Immunotherapy

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To prevent reactivation, antiviral therapy recommended for chemotherapy, immunotherapy.
To prevent reactivation, antiviral therapy recommended for chemotherapy, immunotherapy.

Hepatitis B virus (HBV) screening is recommended for patients undergoing chemotherapy, immunosuppressive therapy, or transplantation, according to research published in Hepatology.

Adrian M. Di Bisceglie, M.D., from the St. Louis University School of Medicine, and colleagues discuss the issue of HBV reactivation, which may occur with a variety of immunosuppressive therapies in benign or malignant disease.

The researchers found that based on the available data, all patients undergoing chemotherapy, immunotherapy, hematopoietic stem cell transplantation, or solid organ transplantation should undergo HBV screening by testing for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen in serum.

To prevent reactivation, appropriate antiviral therapy should be given to patients who are found to be HBsAg positive. Due to the risks associated with a form of HBV reactivation, known as reverse seroconversion, even those who have recovered from HBV will benefit from antiviral therapy in specific circumstances.

RELATED: Anti-CLTA4 Immunotherapy Achieves Antitumor Effects in Small Study of Hepatitis C-Related Hepatocellular Carcinoma

"There is good evidence to support routine screening of all patients for hepatitis B prior to undergoing chemotherapy or immunosuppressive treatment," the authors write. "Use of prompt antiviral treatment appears to diminish the risk of severe or fatal reactivation of hepatitis B."

Reference

  1. Di Bisceglie, Adrian M., MD, et al. "Recent FDA warnings on hepatitis B reactivation with immune-suppressing and anti-cancer drugs: Just the tip of the iceberg?" Hepatology. DOI: 10.1002/hep.27609. December 2014.

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