Department of Medical Oncology, Ghent University Hospital, Gent 9000, Belgium.
Drug Research Unit Ghent, Ghent University Hospital, Gent 9000, Belgium.
Immunotherapy. 2021 Apr;13(5):409-418. doi: 10.2217/imt-2020-0273. Epub 2021 Jan 25.
More patients with chronic hepatitis B and C infection are being exposed to immune checkpoint inhibitors (ICIs), but the safety and efficacy of ICIs in patients with chronic viral hepatitis are still poorly described. To explore this interaction, we identified eight studies of cancer patients with viral hepatitis treated with one or more ICIs, formally assessed tumor responses and safety by grading liver dysfunction. ICIs appear to be relatively safe in HBV/HCV-infected patients, and hepatitis related to viral reactivation is rare. In some patients, viral load regressed during ICI treatment, so immune checkpoints may play a role in viral clearance. HBV/HCV do not appear to be a contraindication to ICIs, although careful clinical and biochemical follow-up is recommended and, whenever necessary, antiviral therapy commenced.
更多慢性乙型肝炎和丙型肝炎感染患者正在接触免疫检查点抑制剂（ICI），但 ICI 在慢性病毒性肝炎患者中的安全性和疗效仍描述不足。为了探索这种相互作用，我们确定了八项研究，这些研究涉及接受一种或多种 ICI 治疗的病毒性肝炎癌症患者，正式通过肝功能分级评估肿瘤反应和安全性。ICI 似乎在 HBV/HCV 感染患者中相对安全，且与病毒再激活相关的肝炎很少见。在一些患者中，ICI 治疗期间病毒载量下降，因此免疫检查点可能在病毒清除中发挥作用。HBV/HCV 似乎不是 ICI 的禁忌证，尽管建议进行仔细的临床和生化随访，并且在必要时开始抗病毒治疗。
