Risk of hepatitis B virus reactivation in patients who are hepatitis B surface antigen negative/antibody to hepatitis B core antigen positive and the role of routine antiviral prophylaxis.

摘要

To the Editor: In Journal of Clinical Oncology, Yeo et al reported a study of 104 patients with CD20~+ diffuse large B-cell lymphoma (DLBCL). Of the 80 patients who were hepatitis B surface antigen (HBsAg) negative, 46 (44.2%) had resolved hepatitis B virus (HBV; ie, they were HBsAg negative but antibody to hepatitis B core antigen [anti-HBc] positive). Twenty-five of these patients were treated with cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP), and none had HBV reactivation; 21 were treated with rituximab plus CHOP (R-CHOP), and five (23.8%) developed HBV reactivation.Our institution presented results of a similar study at the 50th Annual Meeting of the American Society of Hematology (San Francisco, CA). In our cohort, 80 (34.3%) of 233 patients were found to be HBsAg negative/anti-HBc positive. Indeed, the high prevalence of resolved HBV among patients with non-Hodgkin's lymphoma (NHL) reported in both studies suggests that testing for HBsAg status alone may be insufficient for the screening of HBV infection in endemic areas. Patients who are HBsAg negative should also be screened for anti-HBc status.