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

Asia Pac J Clin Oncol. 2019 Feb;15(1):63-68. doi: 10.1111/ajco.13050. Epub 2018 Jul 8.

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.

Keywords: HBs antibody; de novo hepatitis; resolved HBV infection; solid tumor; steroid.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Case-Control Studies
  • Female
  • Hepatitis B / drug therapy
  • Hepatitis B / epidemiology*
  • Hepatitis B / virology*
  • Hepatitis B virus / drug effects*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / virology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Virus Activation / drug effects*

Substances

  • Antiviral Agents