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https://ir.csmu.edu.tw:8080/ir/handle/310902500/24883
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Title: | High Risk of Clinical Relapse in Patients With Chronic Hepatitis B Virus Infection After Cessation of Prophylactic Antiviral Therapy for Rituximab-Containing Chemotherapy |
Authors: | Chang, WY;Chiu, YC;Chiu, FW;Hsu, YC;Tseng, TC;Cheng, PN;Yang, SS;Liu, CJ;Su, TH;Yang, HC;Liu, CH;Chen, PJ;Chen, DS;Kao, JH |
Keywords: | Chronic hepatitis B;prophylaxis;entecavir;tenofovir;hematological cancer;hepatic failure;liver decompensation |
Date: | 2020 |
Issue Date: | 2022-08-09T08:09:33Z (UTC)
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Publisher: | OXFORD UNIV PRESS INC |
ISSN: | 0022-1899 |
Abstract: | Background: Prophylaxis with nucleos(t)ide analogue (NA) is recommended to prevent hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)-positive patients receiving rituximab-based B-cell depletion therapy. However, little is known about the risk of clinical relapse after withdrawal of NA. Methods: We retrospectively analyzed 77 noncirrhotic HBsAg carriers with hematological cancer who received rituximab-containing chemotherapy. All of them received either prophylactic entecavir or tenofovir therapy. The risk of clinical relapse and hepatic decompensation after cessation of NA was explored. Results: Clinical relapse and hepatic decompensation developed in 25 (32.5 %) and 11 (14.3 %) of the patients, respectively, and 2 patients died of hepatic decompensation. Most of the hepatic events occurred within 1 year (20 of 25; 80.0%) after stopping NA. A higher pretreatment viral load (>= 2000 vs <2000 IU/mL) was associated with increased risks of clinical relapse (hazard ratio, 3.47; 95% confidence interval, 1.56-7.73) and hepatic decompensation (9.91; 2.14-45.92). Of 51 patients with pretreatment viral load <2000 IU/mL, clinical relapse occurred in 10 (19.6 %) and hepatic decompensation in 2 (3.9%). Conclusions: Pretreatment HBV DNA >= 2000 IU/mL is associated with increased risk of liver-related disease after cessation of prophylactic NA therapy in patients who received rituximab-containing chemotherapy. |
URI: | http://dx.doi.org/10.1093/infdis/jiaa256 https://www.webofscience.com/wos/woscc/full-record/WOS:000577175900016 https://ir.csmu.edu.tw:8080/handle/310902500/24883 |
Relation: | JOURNAL OF INFECTIOUS DISEASES ,2020 ,v222 ,issue 8 ,p1345-1352 |
Appears in Collections: | [中山醫學大學研究成果] 期刊論文
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