Impact of the timing of hepatitis B virus identification and anti-hepatitis B virus therapy initiation on the risk of adverse liver outcomes for patients receiving cancer therapy

Cancer
Jessica P HwangAnna S F Lok

Abstract

Data on the incidence of adverse liver outcomes are limited for cancer patients with chronic (hepatitis B surface antigen [HBsAg]-positive/hepatitis B core antibody [anti-HBc]-positive) or past (HBsAg-negative/anti-HBc-positive) hepatitis B virus (HBV) after chemotherapy. This study was aimed at determining the impact of test timing and anti-HBV therapy on adverse liver outcomes in these patients. Patients with solid or hematologic malignancies who received chemotherapy between 2004 and 2011 were retrospectively studied. HBV testing and anti-HBV therapy were defined as early at the initiation of cancer therapy and as late after initiation. Outcomes included hepatitis flares, hepatic impairment, liver failure, and death. Time-to-event analysis was used to determine incidence, and multivariate hazard models were used to determine predictors of outcomes. There were 18,688 study patients (80.4% with solid tumors). The prevalence of chronic HBV was 1.1% (52 of 4905), and the prevalence of past HBV was 7.1% (350 of 4905). Among patients with solid tumors, late identification of chronic HBV was associated with a higher risk of hepatitis flare (hazard ratio [HR], 4.02; 95% confidence interval [CI], 1.26-12.86), hepatic impairment (HR, ...Continue Reading

References

Nov 28, 2012·Journal of Oncology Practice·Jessica P HwangMaria E Suarez-Almazor
Nov 12, 2013·BMC Cancer·Jessica P HwangMaria E Suarez-Almazor
Nov 20, 2013·Nature Reviews. Gastroenterology & Hepatology·Jessica P Hwang, Anna S-F Lok
May 13, 2015·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jessica P HwangAndrew S Artz
Jun 5, 2015·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ping-I HsuHsien-Chung Yu
Dec 20, 2015·Gastroenterology·Jang-June ParkUNKNOWN HBRN
Jul 14, 2016·Journal of the National Comprehensive Cancer Network : JNCCN·Lindsey Robert BadenCourtney Smith

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Citations

Mar 21, 2018·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Denise YeoAlexandre Chan
Feb 16, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jessica P HwangMaria E Suarez-Almazor
Jan 31, 2018·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Thomas S Uldrick
Sep 25, 2017·The British Journal of Dermatology·R J de Knegt
Oct 10, 2018·Current Opinion in Infectious Diseases·Jessica P Hwang, Harrys A Torres
Jun 3, 2018·Clinical Medicine : Journal of the Royal College of Physicians of London·Apostolos KoffasPatrick Tf Kennedy

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