Chronic hepatitis B and occult infection in chemotherapy patients - evaluation in oncology and hemato-oncology settings: The CHOICE study.

Nayana Sudevan, Manish Manrai, T V S V G K Tilak, Harshit Khurana, Harikrishnan Premdeep
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Abstract

Background: Reactivation of hepatitis B virus (HBV) infection is a well-known risk that can occur spontaneously or following immunosuppressive therapies, including cancer chemotherapy. HBV reactivation can cause significant morbidity and even mortality, which are preventable if at-risk individuals are identified through screening and started on antiviral prophylaxis.

Aim: To determine the prevalence of chronic HBV (CHB) and occult HBV infection (OBI) among oncology and hematology-oncology patients undergoing chemotherapy.

Methods: In this observational study, the prevalence of CHB and OBI was assessed among patients receiving chemotherapy. Serological markers of HBV infection [hepatitis B surface antigen (HBsAg)/anti-hepatitis B core antigen (HBc)] were evaluated for all patients. HBV DNA levels were assessed in those who tested negative for HBsAg but positive for total anti-HBc.

Results: The prevalence of CHB in the study cohort was determined to be 2.3% [95% confidence interval (95%CI): 1.0-4.2]. Additionally, the prevalence of OBI among the study participants was found to be 0.8% (95%CI: 0.2-2.3).

Conclusion: The findings of this study highlight the importance of screening for hepatitis B infection in oncology and hematology-oncology patients undergoing chemotherapy. Identifying individuals with CHB and OBI is crucial for implementing appropriate antiviral prophylaxis to prevent the reactivation of HBV infection, which can lead to increased morbidity and mortality.

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化疗患者中的慢性乙型肝炎和隐性感染--肿瘤学和血液肿瘤学环境中的评估:CHOICE 研究。
背景:乙型肝炎病毒(HBV)感染再活化是众所周知的风险,可自发发生或在接受免疫抑制疗法(包括癌症化疗)后发生。如果通过筛查发现高危人群并开始进行抗病毒预防,这些感染是可以预防的。目的:确定接受化疗的肿瘤科和血液肿瘤科患者中慢性乙型肝炎病毒(CHB)和隐性乙型肝炎病毒感染(OBI)的患病率:在这项观察性研究中,对接受化疗的患者中CHB和OBI的患病率进行了评估。对所有患者的 HBV 感染血清学标志物[乙型肝炎表面抗原(HBsAg)/抗乙型肝炎核心抗原(HBc)]进行了评估。对 HBsAg 检测阴性但总抗 HBc 检测阳性的患者进行了 HBV DNA 水平评估:研究队列中的 CHB 患病率为 2.3% [95%置信区间 (95%CI):1.0-4.2]。此外,研究参与者的 OBI 患病率为 0.8%(95% 置信区间:0.2-2.3):本研究结果强调了对接受化疗的肿瘤科和血液肿瘤科患者进行乙型肝炎感染筛查的重要性。发现 CHB 和 OBI 感染者对于实施适当的抗病毒预防措施以防止 HBV 感染再次活化至关重要,而 HBV 感染再次活化会导致发病率和死亡率上升。
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