Back to Search
Start Over
Hepatitis B relapse after entecavir or tenofovir alafenamide cessation under anti-viral prophylaxis for cancer chemotherapy.
- Source :
-
Virology journal [Virol J] 2024 Apr 03; Vol. 21 (1), pp. 79. Date of Electronic Publication: 2024 Apr 03. - Publication Year :
- 2024
-
Abstract
- Background: No study has comparing hepatitis B virus (HBV) relapse rates among patients with both cancer and hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) who completed anti-viral prophylaxis for chemotherapy and then stopped taking entecavir or tenofovir alafenamide (TAF).<br />Methods: A total of 227 HBeAg-negative cancer patients without cirrhosis who previously took entecavir (n = 144) or TAF (n = 83) for antiviral prophylaxis were enrolled.<br />Results: The cumulative incidence of virological and clinical relapse at 2 years was 37% and 10.4%, respectively, in the entecavir group, and 46.7% and 19.5%, respectively, in the TAF group. The multivariate analysis revealed that the use of hematologic malignancy, TAF use, and high-viremia group at baseline were independent risk factors for virological relapse, and use of rituximab, TAF use, higher FIB-4 index and high-viremia group at baseline were independent risk factors for clinical relapse. After propensity score-matching, the patients who discontinued TAF therapy still exhibited higher virological (P = 0.031) and clinical relapse rates (P = 0.012) than did those who discontinued entecavir therapy. The patients were allocated to high- (> 2000 IU/mL), moderate- (between 20 and 2000 IU/mL) and low- (< 20 IU/mL) viremia groups. In the high-viremia group, those who had taken TAF for antiviral prophylaxis had higher rates of virological and clinical relapse than did those who had taken entecavir; in the moderate- and low-viremia groups, no significant difference in virological and clinical relapse rates was detected between the entecavir and TAF groups. Three patients experienced hepatic decompensation upon clinical relapse. All three patients were lymphoma and underwent rituximab therapy. One patient developed acute on chronic liver failure and died even though timely retreatment.<br />Conclusions: In patients with both cancer and CHB who underwent antiviral prophylaxis, TAF use was associated with a higher chance of HBV relapse than entecavir use after nucleos(t)ide analogue cessation, particularly in the high-viremia group. Patients who are hematologic malignancy and undergo a rituximab-containing cytotoxic therapy should be monitored closely after withdrawal from prophylactic NA treatment.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Tenofovir therapeutic use
Antiviral Agents
Hepatitis B e Antigens
Viremia
Rituximab therapeutic use
Neoplasm Recurrence, Local prevention & control
Neoplasm Recurrence, Local chemically induced
Neoplasm Recurrence, Local drug therapy
Hepatitis B virus
Adenine therapeutic use
Treatment Outcome
Recurrence
Hepatitis B Surface Antigens
Hepatitis B, Chronic drug therapy
Hepatitis B, Chronic prevention & control
Hematologic Neoplasms chemically induced
Hematologic Neoplasms drug therapy
Guanine analogs & derivatives
Subjects
Details
- Language :
- English
- ISSN :
- 1743-422X
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Virology journal
- Publication Type :
- Academic Journal
- Accession number :
- 38570803
- Full Text :
- https://doi.org/10.1186/s12985-024-02338-6