Department of Gastroenterology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Department of Medical Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Arch Iran Med. 2020 Dec 1;23(12):835-841. doi: 10.34172/aim.2020.111.
Reactivation of the hepatitis B virus (HBV) either during or after chemotherapy may cause serious and sometimes fatal hepatitis. All patients undergoing chemotherapy should therefore be screened in terms of HBV before chemotherapy. The purpose of this research was to identify HBV screening rates in patients with solid cancer undergoing parenteral chemotherapy and to determine the outcomes of patients undergoing HBV screening.
Data for patients undergoing parenteral chemotherapy for solid cancer from January 1, 2012 to December 30, 2018 were retrieved from our electronic health record patient files in this retrospective study. Screening was defined as hepatitis B surface antigen (HBsAg) and/or hepatitis B core antibody (HBcAb) tests carried out within six months prior the first chemotherapy session.
Four thousand fifty-eight (63%) of the 6440 patients who underwent parenteral chemotherapy were screened for HBsAg and/or HBcAb. The proportions of patients screened for HBsAg and HBcAb improved from 38.8% (2012) to 76.3% (2018), and from 0.2% (2012) to 43% (2018), respectively (<0.001). The HBsAg and HBcAb positivity rates were 2.9% and 36.5%, respectively. Antiviral prophylaxis was started in 11.8% of HBsAg-negative/HBcAb-positive patients and 40.5% of HBsAg-positive patients. HBV reactivation did not occur in patients receiving antiviral prophylaxis, but was identified in 7.2% of HBsAg-positive patients and 0.6% of HBsAg-negative/HBcAb-positive patients without antiviral prophylaxis.
Although HBV screening rates before chemotherapy are increasing among solid cancer patients, the rate of initiation of antiviral prophylaxis is still low. It is therefore important to raise awareness regarding HBV reactivation during/after chemotherapy.
乙型肝炎病毒（HBV）在化疗期间或之后的再激活可能导致严重且有时致命的肝炎。因此，所有接受化疗的患者在化疗前都应进行 HBV 筛查。本研究的目的是确定接受静脉化疗的实体瘤患者的 HBV 筛查率，并确定接受 HBV 筛查患者的结局。
本回顾性研究从电子病历患者档案中提取了 2012 年 1 月 1 日至 2018 年 12 月 30 日期间接受静脉化疗的实体瘤患者的数据。筛查定义为在首次化疗前 6 个月内进行的乙型肝炎表面抗原（HBsAg）和/或乙型肝炎核心抗体（HBcAb）检测。
在 6440 名接受静脉化疗的患者中，有 4058 名（63%）接受了 HBsAg 和/或 HBcAb 筛查。筛查 HBsAg 和 HBcAb 的患者比例从 2012 年的 38.8%（2012）提高到 2018 年的 76.3%（2018）和从 2012 年的 0.2%提高到 43%（2018）（<0.001）。HBsAg 和 HBcAb 阳性率分别为 2.9%和 36.5%。在 HBsAg 阴性/ HBcAb 阳性的患者中，11.8%开始接受抗病毒预防治疗，而在 HBsAg 阳性的患者中，40.5%开始接受抗病毒预防治疗。接受抗病毒预防治疗的患者未发生 HBV 再激活，但在未接受抗病毒预防治疗的 HBsAg 阳性患者中发现了 7.2%，在 HBsAg 阴性/ HBcAb 阳性患者中发现了 0.6%。
尽管接受化疗的实体瘤患者的 HBV 筛查率在逐渐提高，但抗病毒预防治疗的启动率仍较低。因此，提高对化疗期间/之后 HBV 再激活的认识非常重要。
