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      Prevalence and risk factors of hepatitis B virus reactivation in patients with solid tumors with resolved HBV infection

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          Abstract

          Background

          Reports of hepatitis B virus (HBV) reactivation in solid tumors are very limited, and their frequencies and risk factors were previously unknown.

          Aim

          To evaluate the prevalence and risk factors of HBV reactivation in patients with solid tumors with resolved HBV infection.

          Methods

          All 1088 patients with solid tumors were assessed for eligibility; 251 patients had resolved HBV infection (negative for HBs antigen and positive for anti‐HBc antibody and/or positive for anti‐HBs antibody), and HBV‐DNA was assessed for 243 of these patients in whom we analyzed the prevalence of HBV reactivation. Risk factors for HBV reactivation were exploratorily evaluated by analysis of a case–control study.

          Results

          The prevalence of HBV‐DNA reactivation was 2.1% (95% confidence interval [CI], 0.3–3.9%). We did not observe any exacerbation of HBV‐DNA by early intervention. A low anti‐HBs antibody titer (<10.0 mIU/mL) and high average daily dexamethasone dose (>1.0 mg/day) were high risk factors, with odds ratios of 5.94 (95% CI, 1.15–30.6, P = 0.03) and 8.69 (95% CI, 1.27–58.8, P = 0.02), respectively.

          Conclusion

          HBV reactivation in solid tumor patients was relatively rare. Therefore, risk factors that can identify targets for HBV screening must be determined in future studies.

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          Most cited references20

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          2016 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting and of nausea and vomiting in advanced cancer patients.

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            Antiemetics: American Society of Clinical Oncology Focused Guideline Update.

            To update a key recommendation of the American Society of Clinical Oncology antiemetic guideline. This update addresses the use of the oral combination of netupitant (a neurokinin 1 [NK1] receptor antagonist) and palonosetron (a 5-hydroxytryptamine-3 [5-HT3] receptor antagonist) for the prevention of acute and delayed nausea and vomiting in patients receiving chemotherapy.
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              Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta-analysis.

              Patients with resolved hepatitis B virus (HBV) infection who are treated for hematological malignancies remain at risk for HBV reactivation. Because of conflicting studies about whether the antibody to hepatitis B surface antigen (anti-HBs) protects against reactivation in patients with resolved infection (hepatitis B surface antigen negative) receiving chemotherapy for hematological malignancies, we conducted a meta-analysis to determine if anti-HBs reduces HBV reactivation risk. We sought English-language studies through March 1, 2016, in Medline and other sources that examined reactivation in patients with resolved HBV infection receiving chemotherapy for hematologic malignancies. The absolute risks and odds ratio (OR) of reactivation with versus without anti-HBs were estimated in random-effects model meta-analyses. In 20 studies involving 1,672 patients not receiving antiviral prophylaxis, the reactivation risk was 14% (95% confidence interval [CI] 9.4%-19%) in 388 patients who had antibodies to hepatitis B core antigen only versus 5.0% (95% CI 3.0%-7.0%) in 1,284 patients who also had anti-HBs. Anti-HBs reduced reactivation risk with a pooled OR of 0.21 (95% CI 0.14-0.32) versus patients with antibody to hepatitis B core antigen only. Similar results were found when limiting the analysis to rituximab chemotherapy (OR = 0.19, 95% CI 0.11-0.32) and lymphoma (OR = 0.18, 95% CI 0.11-0.28).
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                Author and article information

                Contributors
                tkkotake@gmail.com
                Journal
                Asia Pac J Clin Oncol
                Asia Pac J Clin Oncol
                10.1111/(ISSN)1743-7563
                AJCO
                Asia-Pacific Journal of Clinical Oncology
                John Wiley and Sons Inc. (Hoboken )
                1743-7555
                1743-7563
                08 July 2018
                February 2019
                : 15
                : 1 ( doiID: 10.1111/ajco.2019.15.issue-1 )
                : 63-68
                Affiliations
                [ 1 ] Department of Medical Oncology Kobe City Medical Center General Hospital Kobe Japan
                [ 2 ] Department of Clinical Oncology Faculty of Medicine Kagawa University Kagawa Japan
                [ 3 ] Department of Nursing Kobe City Medical Center General Hospital Kobe Japan
                [ 4 ] Clinical & Translational Research Center Kobe University Hospital Kobe Japan
                [ 5 ] Department of Pharmacy Kobe City Medical Center General Hospital Kobe Japan
                [ 6 ] Department of General and Transplant Surgery Kobe City Medical Center General Hospital Kobe Japan
                [ 7 ] Department of Gastroenterology Kobe City Medical Center General Hospital Kobe Japan
                Author notes
                [*] [* ] Correspondence

                Takeshi Kotake, MD, Breast Surgery Department, Kyoto University Hospital, 54, Shogoin‐Kawaharacho, Sakyo‐ku, Kyoto, Japan.

                Email: tkkotake@ 123456gmail.com

                Author information
                http://orcid.org/0000-0002-9426-2612
                Article
                AJCO13050
                10.1111/ajco.13050
                7379615
                29984542
                54dfeb39-ab2b-487c-a115-a37cb963f545
                © 2018 The Authors. Asia‐Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 30 November 2017
                : 18 June 2018
                Page count
                Figures: 2, Tables: 2, Pages: 6, Words: 3828
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                February 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:24.07.2020

                de novo hepatitis,hbs antibody,resolved hbv infection,solid tumor,steroid

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