Shui Li-Ping, Zhu Yan, Duan Xiao-Qin, Chen Yu-Ting, Yang Li, Tang Xiao-Qiong, Zhang Hong-Bin, Xiao Qing, Wang Li, Liu Lin, Luo Xiao-Hua
Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Hematology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
J Med Virol. 2023 Feb;95(2):e28549. doi: 10.1002/jmv.28549.
Patterns of hepatitis B virus reactivation (HBV-R) in HBsAg (-)/HBcAb (+) patients with B-cell non-Hodgkin lymphoma (NHL) receiving rituximab based immunochemotherapy have not been well described. The retrospective study included 222 HBsAg (-)/HBcAb (+) NHL patients as training cohort and 127 cases as validation cohort. The incidence of HBV-R in HBsAg (-)/HBcAb (+) B-cell NHL patients was 6.3% (14/222), of which that in HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was 23.7% (9/38). Multivariate analysis showed that HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) correlated with a high risk of HBV-R in B-cell lymphoma patients (training phase hazard ratio [HR], 10.123; 95% confidence interval [CI], 3.389-30.239; p < 0.001; validation phase HR, 18.619; 95% CI, 1.684-205.906; p = 0.017; combined HR, 12.264; 95% CI, 4.529-33.207; p < 0.001). In the training cohort, the mortality rate of HBsAg (-)/HBcAb (+) B-cell NHL caused by HBV-R was 14.3% (2/14) while that for HBV reactivated HBsAg (-)/HBsAb (-)/HBeAg (-)/HBeAb (+)/HBcAb (+) population was up to 44.4% (4/9). As a high incidence of HBV-R and high mortality after HBV-R was found in HBsAg (-)/HBsAb (-)/HBcAb (+)/HBeAg (-)/HBeAb (+) patients with B-cell NHL receiving rituximab based immunochemotherapy, prophylactic antiviral therapy is recommended for these patients.
在接受基于利妥昔单抗的免疫化疗的乙肝表面抗原（HBsAg）阴性/乙肝核心抗体（HBcAb）阳性的B细胞非霍奇金淋巴瘤（NHL）患者中，乙肝病毒再激活（HBV-R）模式尚未得到充分描述。这项回顾性研究纳入了222例HBsAg阴性/HBcAb阳性的NHL患者作为训练队列，127例作为验证队列。HBsAg阴性/HBcAb阳性的B细胞NHL患者中HBV-R的发生率为6.3%（14/222），其中HBsAg阴性/乙肝表面抗体（HBsAb）阴性/乙肝e抗原（HBeAg）阴性/乙肝e抗体（HBeAb）阳性/HBcAb阳性人群中的发生率为23.7%（9/38）。多因素分析显示，HBsAg阴性/HBsAb阴性/HBeAg阴性/HBeAb阳性/HBcAb阳性与B细胞淋巴瘤患者HBV-R的高风险相关（训练阶段风险比[HR]，10.123；95%置信区间[CI]，3.389-30.239；p<0.001；验证阶段HR，18.619；95%CI，1.684-205.906；p=0.017；合并HR，12.264；95%CI，4.529-33.207；p<0.001）。在训练队列中，HBsAg阴性/HBcAb阳性的B细胞NHL因HBV-R导致的死亡率为14.3%（2/14），而HBV再激活的HBsAg阴性/HBsAb阴性/HBeAg阴性/HBeAb阳性/HBcAb阳性人群的死亡率高达44.4%（4/9）。鉴于在接受基于利妥昔单抗的免疫化疗的HBsAg阴性/HBsAb阴性/HBcAb阳性/HBeAg阴性/HBeAb阳性的B细胞NHL患者中发现HBV-R的高发生率以及HBV-R后的高死亡率，建议对这些患者进行预防性抗病毒治疗。
