Zilin Tang1, Xiaodong Li2, Shunquan Wu2, Yan Liu2, Yan Qiao1, Dongping Xu3,4, Jin Li5,6. 1. Clinical Medical School, Guilin Medical University, Guilin, 541004, Guangxi Zhuang Autonomous Region, China. 2. Research Center for Clinical and Translational Medicine/Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, 100039, China. 3. Clinical Medical School, Guilin Medical University, Guilin, 541004, Guangxi Zhuang Autonomous Region, China. xudongping302@sina.com. 4. Research Center for Clinical and Translational Medicine/Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, 100039, China. xudongping302@sina.com. 5. Clinical Medical School, Guilin Medical University, Guilin, 541004, Guangxi Zhuang Autonomous Region, China. lijin302@hotmail.com. 6. Research Center for Clinical and Translational Medicine/Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, 100039, China. lijin302@hotmail.com.
Abstract
BACKGROUND: Hepatitis B surface antigen (HBsAg)-negative/hepatitis B core antibody (HBcAb)-positive patients with undetectable serum hepatitis B virus (HBV) DNA have experienced and resolved hepatitis B virus (HBV) infection. Lymphoma patients with resolved HBV infection have high risk of HBV reactivation when treated with robust immunosuppressive agents, but the reported rate varies extensively between different studies. This study aims to estimate the risk of HBV reactivation in HBsAg-negative/HBcAb-positive patients receiving rituximab-containing chemotherapy for lymphoma. METHODS: Databases were searched for papers published in English until 8 August 2016. The pooled risk of HBV reactivation was estimated using a random-effects model. RESULTS: Data from 15 studies were retrieved, including a total of 1312 HBsAg-negative/HBcAb-positive lymphoma patients treated with rituximab-containing chemotherapy. The results revealed HBV reactivation rate of 9.0 % [95 % confidence interval (CI) 0.05-0.15]. In subgroup analysis, the reactivation rates for prospective and retrospective studies were 17 % (I 2 = 87.3 %; 95 % 0.08-0.39, p < 0.001) and 7 % (I 2 = 43.1 %; 95 % CI 0.05-0.11, p = 0.07), respectively. CONCLUSIONS: This meta-analysis confirms a measurable and potentially substantial risk of HBV reactivation in HBsAg-negative/HBcAb-positive patients with rituximab treatment for lymphoma. Prophylactic use of anti-HBV agents should be seriously considered for such patients.
BACKGROUND:Hepatitis B surface antigen (HBsAg)-negative/hepatitis B core antibody (HBcAb)-positive patients with undetectable serum hepatitis B virus (HBV) DNA have experienced and resolved hepatitis B virus (HBV) infection. Lymphomapatients with resolved HBV infection have high risk of HBV reactivation when treated with robust immunosuppressive agents, but the reported rate varies extensively between different studies. This study aims to estimate the risk of HBV reactivation in HBsAg-negative/HBcAb-positive patients receiving rituximab-containing chemotherapy for lymphoma. METHODS: Databases were searched for papers published in English until 8 August 2016. The pooled risk of HBV reactivation was estimated using a random-effects model. RESULTS: Data from 15 studies were retrieved, including a total of 1312 HBsAg-negative/HBcAb-positive lymphomapatients treated with rituximab-containing chemotherapy. The results revealed HBV reactivation rate of 9.0 % [95 % confidence interval (CI) 0.05-0.15]. In subgroup analysis, the reactivation rates for prospective and retrospective studies were 17 % (I 2 = 87.3 %; 95 % 0.08-0.39, p < 0.001) and 7 % (I 2 = 43.1 %; 95 % CI 0.05-0.11, p = 0.07), respectively. CONCLUSIONS: This meta-analysis confirms a measurable and potentially substantial risk of HBV reactivation in HBsAg-negative/HBcAb-positive patients with rituximab treatment for lymphoma. Prophylactic use of anti-HBV agents should be seriously considered for such patients.
Entities:
Keywords:
Hepatitis B reactivation; Hepatitis B virus; Lymphoma; Rituximab
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