Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Mar 25, 2024; 13(1): 89104
Published online Mar 25, 2024. doi: 10.5501/wjv.v13.i1.89104
Chronic hepatitis B and occult infection in chemotherapy patients - evaluation in oncology and hemato-oncology settings: The CHOICE study
Nayana Sudevan, Manish Manrai, T V S V G K Tilak, Harshit Khurana, Harikrishnan Premdeep
Nayana Sudevan, Harikrishnan Premdeep, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India
Manish Manrai, Department of Gastroenterology, Command Hospital Cantonment Rd, Sadar Bazaar, Cantonment, Lucknow, Uttar Pradesh, India 226002
T V S V G K Tilak, Department of Internal Medicine, Command Hospital, Bangalore 560007, India
Harshit Khurana, Department of Geriatric Medicine, Armed Forces Medical College, Pune 411040, India
Author contributions: Manrai M conceptualized and supervised the study and was involved with obtaining resources, data collection, editing, and validation; Sudevan N conducted the study and was involved in writing the manuscript; Tilak TVSVGK and Khurana H were involved with obtaining resources and data curation, Premdeep H was involved with data curation and editing.
Institutional review board statement: The study protocol was reviewed and approved by the relevant ethical committee of Armed Forces Medical College, Pune, Maharashtra, India. Informed consent was obtained from all participants before their inclusion in the study. Confidentiality and privacy of patient information were strictly maintained throughout the study.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Informed consent was obtained from all participants before their inclusion in the study. Confidentiality and privacy of patient information were strictly maintained throughout the study.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Manish Manrai, FRCPE, MBBS, MD, Professor, Department of Gastroenterology, Command Hospital Cantonment Rd, Sadar Bazaar, Cantonment, 226002 Lucknow, Uttar Pradesh, India. manishmanrai75@yahoo.com
Received: October 20, 2023
Peer-review started: October 20, 2023
First decision: November 21, 2023
Revised: December 27, 2023
Accepted: January 24, 2024
Article in press: January 24, 2024
Published online: March 25, 2024
Abstract
BACKGROUND

Reactivation of hepatitis B virus (HBV) infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies, including cancer chemotherapy. HBV reactivation can cause significant morbidity and even mortality, which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.

AIM

To determine the prevalence of chronic HBV (CHB) and occult HBV infection (OBI) among oncology and hematology-oncology patients undergoing chemotherapy.

METHODS

In this observational study, the prevalence of CHB and OBI was assessed among patients receiving chemotherapy. Serological markers of HBV infection [hepatitis B surface antigen (HBsAg)/anti-hepatitis B core antigen (HBc)] were evaluated for all patients. HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.

RESULTS

The prevalence of CHB in the study cohort was determined to be 2.3% [95% confidence interval (95%CI): 1.0-4.2]. Additionally, the prevalence of OBI among the study participants was found to be 0.8% (95%CI: 0.2-2.3).

CONCLUSION

The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy. Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection, which can lead to increased morbidity and mortality.

Keywords: Hepatitis B virus, Chronic hepatitis B, Occult B infection, Oncology, Hepatitis B reactivation, Hematology-oncology

Core Tip: Hepatitis B virus (HBV) reactivation, a significant risk for individuals undergoing immunosuppressive therapy such as cancer chemotherapy, can lead to preventable morbidity and mortality. Our observational study determined the prevalence of chronic HBV (CHB) infection and occult HBV infection (OBI) in oncology and hematology-oncology patients receiving chemotherapy. Our results showed a 2.3% prevalence of CHB and 0.8% prevalence of OBI in our study cohort, underscoring the critical importance of routinely screening oncology and hematology-oncology patients for HBV infection. Identifying those with CHB and OBI is vital for promptly initiating antiviral prophylaxis, which can prevent the reactivation of HBV infection.