Testing for hepatitis B infection in prospective chemotherapy patients: A retrospective study

doi:10.3748/wjg.v19.i6.923

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Feb 14, 2013; 19(6): 923-930
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.923

Table 1 Characteristics of 5616 cancer patients who received chemotherapy n (%)

Characteristics	Hematological malignancy	Solid tumor		Total
	(n = 281)	HCC(n = 237)	Others(n = 5098)	(n = 5616)
Age (yr), mean (range)	50.5 (18-83)	53.1 (39-67)	54.4 (41-67)	54.1 (29-79)
Sex
Men	176 (62.6)	201 (84.8)	2567 (50.4)	2944 (52.4)
Women	105 (37.4)	36 (17.9)	2531 (49.6)	2672 (47.6)
Surgical history	22 (7.8)	6 (2.5)	2157 (42.3)	2185 (38.9)
History of HBV infection¹	27 (9.6)	126 (53.2)	179 (3.5)	332 (5.9)
Aminotransferase
Normal (< 58 IU/mL)	251 (89.3)	144 (60.8)	4816 (94.5)	5211 (92.8)
Elevated	30 (10.7)	93 (39.2)	282 (5.5)	405 (7.2)

¹History of hepatitis B surface antigen positivity. HCC: Hepatocellular carcinoma; HBV: Hepatitis B virus.

Table 2 Univariate logistic regression analysis of factors associated with testing for hepatitis B virus serological markers prior to chemotherapy, but excluding those tested preoperatively (n = 3431)

	No.	Screening n (%)	P value
Age (yr)			< 0.01
≤ 50	1215	240 (19.8)
> 50	2216	345 (15.6)
Sex			< 0.05
Men	2031	374 (18.4)
Women	1400	211 (15.1)
Rituximab therapy^a			< 0.01
Yes	49	25 (51.0)
No	3382	560 (16.6)
History of HBV infection			< 0.01
Yes	141	45 (31.9)
No	3290	540 (16.4)
ALT and/or AST^b			< 0.01
Abnormal	205	128 (62.4)
Normal	3226	457 (14.2)
Types of tumor^c			< 0.01
Hematological	259	112 (43.2)
Solid	3172	473 (14.9)	< 0.05
Liver cancer	78	18 (23.1)
Others	3094	455 (14.7)

^aP = 0.038 (OR: 1.96, 95%CI: 1.04-3.67);

^bP < 0.001 (OR: 10.88, 95%CI: 8.01-14.78);

^cP < 0.001 (OR: 4.17, 95%CI: 3.10-5.61). OR: Odds ratio; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.

Table 3 Prevalence of hepatitis B virus serum markers and DNA in 2770 patients n (%)

	No.	HBsAg+	HBsAb+	HBeAg+	HBeAb+	Isolated HBcAb+	HBV-sm positive¹	Screening HBV DNA²
Total	2770	372 (13.4)	1367 (49.4)	43 (1.6)	600 (21.7)	284 (10.3)	656 (23.7)	177 (27.0)
Age (yr)
≤ 20	27	2 (7.4)	14 (51.9)	1 (3.7)	2 (7.4)	1 (3.7)	3 (11.1)	1 (33.3)
>20	2743	370 (13.5)	1353 (49.3)	42 (1.5)	598 (21.8)	283 (10.3)	653 (23.8)	176 (27.0)
Sex
Women	1495	144 (9.6)	780 (52.2)	15 (1.0)	280 (18.7)	146 (9.8)	290 (19.4)	52 (17.9)
Men	1275	228 (17.9)	587 (46.7	28 (2.2)	320 (25.5)	138 (10.8)	366 (28.7)	125 (34.2)
Types of tumor
Hematological	134	21 (15.7)	51 (38.1)	3 (2.2)	26 (19.4)	7 (5.2)	28 (20.9)	23 (82.1)
Solid	2636	351 (13.3)	1316 (49.9)	40 (1.5)	574 (21.8)	277 (10.5)	628 (23.8)	154 (24.5)
Liver cancer	177	114 (64.4)	45 (25.4)	17 (9.6)	114 (64.4)	27 (15.3)	141 (79.7)	68 (48.2)
Others	2459	207 (8.4)	1271 (41.7)	23 (0.9)	114 (64.4)	250 (10.2)	487 (19.8)	84 (3.5)

¹HBV-sm positive: HBV serological marker positive (HBsAg positive and/or isolated HBcAb positive);

²Percentage equals the screening number of HBV DNA/number of HBV-sm positive. HBV: Hepatitis B virus; HBsAg: Hepatitis B surface antigen; HBsAb: Hepatitis B surface antibody; HBeAg: Hepatitis B e antigen; HBeAb: Hepatitis B e antibody; HBcAb: Hepatitis B core antibody.

Table 4 Characteristics of 160 hepatitis B surface antigen-seropositive cancer patients undergoing cytotoxic chemotherapy n (%)

	Patients developed HBV reactivation (n = 53)	Patients who did not develop HBV reactivation (n = 107)	P value
Sex^a			< 0.05
Men	43 (38.4)	69 (61.6)
Women	10 (20.8)	38 (79.2)
Age (yr), median (range)	51.5 (24.8-78.2)	52.9 (27.8-77.9)
Tumor type^b			< 0.05
Lymphomas	10 (55.6)	8 (44.4)
Solid tumor	43 (30.3)	99 (69.7)
Liver cancer	25 (35.7)	45 (64.3)
Others	18 (25.0)	54 (75.0)
ALT levels, median (range) (normal < 58 IU/mL)	69.1 (21.9-116.3)	55.7 (18.2-93.2)
HBeAg status^c			< 0.01
Positive	17 (73.9)	6 (26.1)
Negative	36 (26.3)	101 (73.7)
HBV DNA status^d			< 0.01
Positive	47 (45.2)	57 (54.8)
Negative	6 (10.7)	50 (89.3)
Use of rituximab			< 0.05
Yes	6 (60)	4 (40)
No	47 (31.3)	103 (68.7)
Use of corticosteroids			< 0.05
Yes	8 (61.5)	5 (38.5)
No	45 (30.6)	102 (69.4)
Receiving antiviral therapy			< 0.01
Yes	1 (2.1)	46 (97.9)
No	52 (46.0)	61 (54.0)

^aP = 0.040 (OR: 2.634, 95%CI: 1.046-6.63);

^bP = 0.002 (OR: 5.700, 95%CI: 1.869-17.380);

^cP = 0.000 (OR: 6.064, 95%CI: 2.213-16.621);

^dP = 0.006 (OR: 5.982, 95%CI: 1.689-21.194). OR: Odds ratio; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; HBeAg: Hepatitis B e antigen.

Citation: Wang Y, Luo XM, Yang D, Zhang J, Zhuo HY, Zhang J, Jiang Y. Testing for hepatitis B infection in prospective chemotherapy patients: A retrospective study. World J Gastroenterol 2013; 19(6): 923-930
URL: https://www.wjgnet.com/1007-9327/full/v19/i6/923.htm
DOI: https://dx.doi.org/10.3748/wjg.v19.i6.923