Risk of hepatitis B reactivation in HBsAg-negative/HBcAb-positive patients with undetectable serum HBV DNA after treatment with rituximab for lymphoma: a meta-analysis

摘要

BackgroundHepatitis?B surface antigen (HBsAg)-negative/hepatitis?B core antibody (HBcAb)-positive patients with undetectable serum hepatitis?B virus (HBV) DNA have experienced and resolved hepatitis B virus (HBV) infection. Lymphoma patients with resolved HBV infection have high risk of HBV reactivation when treated with robust immunosuppressive agents, but the reported rate varies extensively between different studies. This study aims to estimate the risk of HBV reactivation in HBsAg-negative/HBcAb-positive patients receiving rituximab-containing chemotherapy for lymphoma.MethodsDatabases were searched for papers published in English until 8 August 2016. The pooled risk of HBV reactivation was estimated using a random-effects model.ResultsData from 15 studies were retrieved, including a total of 1312 HBsAg-negative/HBcAb-positive lymphoma patients treated with rituximab-containing chemotherapy. The results revealed HBV reactivation rate of 9.0?% [95?% confidence interval (CI) 0.05–0.15]. In subgroup analysis, the reactivation rates for prospective and retrospective studies were 17?% (I2?=?87.3?%; 95?% 0.08–0.39, p?