Hepatitis B reactivation among 1962 patients with hematological malignancy in Taiwan.
BMC Gastroenterol
; 18(1): 6, 2018 Jan 08.
Article
en En
| MEDLINE
| ID: mdl-29310589
ABSTRACT
BACKGROUND:
The risk of Hepatitis B virus (HBV) reactivation in patients with different hematological malignancy except lymphoma were rarely known before.METHODS:
A total of 1962 patients with hematological malignancy were enrolled and followed-up at the National Taiwan University Hospital between 2008 and 2013. The clinical characteristics, HBV serology, and laboratory data were retrospectively reviewed and analyzed.RESULTS:
A total of 1962 patients comprising 1048 men and 914 women were studied. The median age of the patients was 55 years (range, 15-97 years). Chronic HBV carriage was documented at diagnosis of hematological malignancy in 286 (14.6%) patients. A total of 171 (59.8%) of the 286 HBV carriers received primary prophylaxis with anti-HBV agents. Of the HBV carriers, 97 (33.9%) developed hepatitis B reactivation during or after chemotherapy, including 59 patients who had discontinued antiviral therapy. The incidence of hepatitis B reactivation among patients with hematological malignancy and HBV carriage was 10.4 per 100 person-years. A multivariate analysis revealed hepatocellular carcinoma (p < 0.001) and antiviral prophylaxis use (p < 0.001) were independent risk factors of HBV reactivation in HBV carriers. Of the 1676 patients with initial negative hepatitis B surface antigen (HBsAg) counts, 41 (2.4%) experienced hepatitis B reactivation, reverse seroconversion of HBsAg, and lost their protective hepatitis B surface antibody (anti-HBs). A multivariate analysis revealed that diabetes mellitus (p = 0.005, odds ratio (OR) 0.218, 95% confidence interval (CI) 0.076-0.629), allogeneic transplantation (p = 0.013, OR 0.182, 95% CI 0.047-0.701), liver cirrhosis (p < 0.001, OR 0.002, 95% CI 0-0.047), low anti-HBs titers (p = 0.016, OR 0.020, 95% CI 0.001-0.480), and positive hepatitis B core antibody (p = 0.013, OR 0.070, 95% CI 0.009-0.571) were independent risk factors of positive seroconversion of HBsAg in patients with hematological malignancy.CONCLUSIONS:
The incidence of HBV reactivation among the patients with varying subtypes of hematological malignancy is similar. Prophylaxis with anti-HBV agents critically reduced the risk of hepatitis B reactivation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Activación Viral
/
Virus de la Hepatitis B
/
Neoplasias Hematológicas
/
Hepatitis B Crónica
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
BMC Gastroenterol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Taiwán