Ishikawa Toru, Suzuki Mitsuyuki, Honma Terasu, Yoshida Toshiaki
Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.
Department of Pharmacology, Saiseikai Niigata Hospital, Niigata, Japan.
Transl Gastroenterol Hepatol. 2025 Jan 9;10:5. doi: 10.21037/tgh-24-103. eCollection 2025.
Prevention of hepatitis B virus (HBV) reactivation is a very important issue, but there is still no clear strategy. This study aimd to develop and evaluate an in-hospital collaboration flow to prevent HBV reactivation, guided by the Japanese Society of Hepatology (JSH) guidelines.
We have strengthened and implemented a screening system and for HBV reactivation from February 2022 to January 2023. We assessed the administration of nucleic acid analogs (NAs) in hepatitis B surface antigen (HBsAg) or HBV DNA-positive cases, the detection rate of HBs or hepatitis B core (HBc) antibodies in HBsAg or HBV DNA-negative cases, and the follow-up status of HBV DNA testing. A total of 1,195 patients were included, with exclusions based on the judgement of no need for testing by the attending physician.
Among 1,172 tested patients, 1.88% (n=22) were HBsAg or HBV DNA-positive, all of whom received NA therapy. Among 1,150 HBsAg or HBV DNA-negative cases, 9.91% (n=114) were HBs or HBc antibody-positive, with 82.5% (n=94) undergoing HBV DNA testing. Over the years, the HBV DNA measurement rates increased significantly to 82.5% in 2022.
The implemented screening regimen resulted in high and improving testing rates over time. Most HBsAg or HBV DNA-positive cases were treated with tenofovir alafenamide (TAF), highlighting its potential benefits in terms of safety and adherence. Continued validation and adaptation of the screening system are necessary to further prevent HBV reactivation.
预防乙型肝炎病毒（HBV）再激活是一个非常重要的问题，但目前仍没有明确的策略。本研究旨在制定并评估一种以日本肝病学会（JSH）指南为指导的院内协作流程，以预防HBV再激活。
我们在2022年2月至2023年1月期间加强并实施了HBV再激活筛查系统。我们评估了乙型肝炎表面抗原（HBsAg）或HBV DNA阳性病例中核酸类似物（NAs）的使用情况、HBsAg或HBV DNA阴性病例中HBs或乙型肝炎核心（HBc）抗体的检测率以及HBV DNA检测的随访情况。共纳入1195例患者，根据主治医生判断无需检测的情况进行排除。
在1172例接受检测的患者中，1.88%（n = 22）为HBsAg或HBV DNA阳性，所有这些患者均接受了NA治疗。在1150例HBsAg或HBV DNA阴性病例中，9.91%（n = 114）为HBs或HBc抗体阳性，其中82.5%（n = 94）接受了HBV DNA检测。多年来，HBV DNA检测率显著提高，2022年达到82.5%。
实施的筛查方案随着时间推移导致检测率较高且不断提高。大多数HBsAg或HBV DNA阳性病例接受了替诺福韦艾拉酚胺（TAF）治疗，凸显了其在安全性和依从性方面的潜在益处。持续验证和调整筛查系统对于进一步预防HBV再激活是必要的。
