乙型肝炎病毒在接受全身抗肿瘤治疗的实体瘤患者中的再激活。
Hepatitis B virus reactivation in patients with solid tumors receiving systemic anticancer treatment.
机构信息
Gastro-Enterology and Digestive Oncology Unit, Cochin Teaching Hospital, AP-HP, Université Paris Descartes, Sorbonne Paris Cité, Paris.
Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif
出版信息
Ann Oncol. 2016 Dec;27(12):2172-2184. doi: 10.1093/annonc/mdw414. Epub 2016 Nov 1.
BACKGROUND
Hepatitis B virus (HBV) reactivation is a well-known risk during chemotherapy for hematological malignancies with reported rates ranging between 14% and 72%. However, there is a paucity of data regarding HBV infection management and reactivation risk in patients receiving systemic treatments for solid tumors.
DESIGN
We conducted a PubMed search for publications from January 1990 until May 2016 related to HBV reactivation. The search terms were 'hepatitis B reactivation', cross-referenced with 'chemotherapy', then 'hepatitis B' cross-referenced with International Non-proprietary Name of each of the most used chemotherapy drugs in solid tumors.
RESULTS
From these data, a grading of HBV reactivation risk and recommendations for management are given for most frequently used anticancer drugs in solid tumors.
CONCLUSION
Most drugs used for the treatment of solid tumors can induce hepatitis B reactivation in HBs antigen-positive patients. HBV screening can be recommended before systemic treatment initiation. Pre-emptive antiviral treatment can reduce the risk of HBV reactivation and prevent chemotherapy disruption.
背景
乙型肝炎病毒（HBV）再激活是血液系统恶性肿瘤化疗中一个众所周知的风险，其报告发生率在 14%至 72%之间。然而，关于接受实体瘤系统治疗的患者的 HBV 感染管理和再激活风险的数据却很少。
设计
我们在 PubMed 上进行了检索，以查找 1990 年 1 月至 2016 年 5 月期间与 HBV 再激活相关的出版物。检索词为“hepatitis B reactivation”，与“chemotherapy”交叉引用，然后与“hepatitis B”交叉引用了在实体瘤中最常使用的每种化疗药物的国际非专利名称。
结果
根据这些数据，对在实体瘤中最常使用的抗癌药物进行了 HBV 再激活风险分级和管理建议。
结论
大多数用于治疗实体瘤的药物可使 HBs 抗原阳性患者发生乙型肝炎再激活。在开始全身治疗前可推荐进行 HBV 筛查。预防性抗病毒治疗可以降低 HBV 再激活的风险，并防止化疗中断。
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