Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies treated with anticancer therapy

Table 2 Prospective studies on HBV reactivation in haematology patients with resolved hepatitis B virus infection (HBsAg negative anti-HBc positive patients)

Author/year	Disease	Study design	Sample size	Definition of HBV reactivation	Rate of HBV reactivation	Risk factor(s) identified for HBV reactivation	Death from HBV reactivation
Yeo et al[99] 2009	Diffuse large B-cell lymphoma	All patients were observed every 2-3 wk during anticancer therapy and every 6-8 wk for 9 mo after anticancer therapy	46	HBsAg seroconversion (the reappearance of HBsAg) with an increase in HBV DNA levels when compared with baseline HBV DNA levels, in the absence of acute infection with HAV, HCV, or other systemic infections	25% in patients receiving R-CHOP	Absence of anti-HBs, use of rituximab and male sex	20% died of HBV reactivation
		Start lamivudine upon HBV reactivation
Huang et al[107] 2013	B-cell lymphoma	Entecavir prophylaxis (continued until 3 mo after completing chemotherapy) vs preemptive treatment	80	Elevation of HBV viral load to 2000 IU/mL with two consecutive determinations (2 wk apart)	Incidence was 4.3% in entecavir group and 25.9% in the control group at 1.5 yr	Lack of entecavir prophylaxis	Nil
Seto et al[45] 2014	CD20 positive B-cell lymphoma	HBV DNA monitoring every 4 wk	63	HBV DNA ≥ 10 IU/mL	2-yr cumulative rate 41.5%	Anti-HBs < 10 mIU/mL	Nil
		Start entecavir upon detection of HBV reactivation
Hsu et al[16] 2014	CD20 positive B-cell lymphoma	HBV DNA monitoring every 4 wk	150	> 10-fold increase in HBV DNA, compared with previous nadir levels	Incidence was 10.4%	Absence of anti-HBs	Nil
		Start entecavir upon detection of HBV reactivation
Kusumoto et al[46] 2015	CD20 positive B-cell lymphoma	HBV DNA monitoring every 4 wk	269	HBV DNA ≥ 11 IU/mL	Incidence was 8.3% at 1.5 yr	Anti-HBs < 10 mIU/mL and baseline HBV DNA below level of quantification	Nil
		Start entecavir upon detection of HBV reactivation

HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HBc: Hepatitis B core antigen.