國家衛生研究院 NHRI:Item 3990099045/10550
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    题名: Prediction of hepatitis B virus reactivation in lymphoma patients with resolved hepatitis B virus infection who received rituximab-containing chemotherapy: The roles of antiHBc/antiHBs quantification
    作者: Yang, HC;Tsou, HH;Pei, SN;Chang, CS;Chen, JH;Yao, M;Lin, SJ;Lin, J;Liu, TW;Chen, PJ;Cheng, AL;Hsu, C;Group, Taiwan Cooperative Oncology
    贡献者: Division of Biostatistics and Bioinformatics;National Institute of Cancer Research
    摘要: Background and Aims: Prophylactic antiviral therapy was recommended to prevent HBV reactivation for lymphoma patients with resolved HBV infection who received rituximab-containing chemotherapy. This study sought to identify high-risk patients by measuring baseline levels of serum anti-HBc and anti-HBs. Methods: We prospectively followed the HBV DNA levels of 197 lymphoma patients with resolved HBV infection who received rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy and started antiviral therapy upon HBV reactivation, defined as a greater than 10-fold increase in HBV DNA compared with previous nadir levels (www.clinicaltrial.gov identifier: NCT 00931229). Anti-HBc and anti-HBs levels were measured by double antigen sandwich immunoassay and enzyme immunoassay. Receiver operating characteristic curve analysis was used to determine optimal baseline anti-HBc/anti-HBs levels for prediction of HBV reactivation. Results: The median baseline anti-HBc and anti-HBs levels were 4.25 IU/mL (range 0.23–191.86) and 72.3 mIU/mL (range 0–12513.5) for the 192 patients with enough serum samples for analysis. High anti-HBc (>=6.41 IU/mL) and low anti-HBs (<56.48 mIU/mL) were significantly associated with high risk of HBV reactivation (odds ratio 5.42, and 8.87, respectively, p < 0.001). The cumulative incidence of HBV reactivation at 15 months was 45.8% (95% CI 27.3–64.2) for patients with both high anti-HBc and low anti-HBs at baseline (36 of 192 patients) and 3.0% – 9.6% in other patients (p < 0.001). HBV reactivation, when considered as a time-dependent covariate, independently predicted inferior overall survival (HR 2.41, 95% C.I. 1.15–5.05, p = 0.02). Conclusions: Baseline anti-HBc/anti-HBs levels may predict HBV reactivation. Efficacy of prophylactic antiviral therapy for the long-term clinical outcome should be explored.
    日期: 2017
    關聯: Journal of Hepatology. 2017;66(1, Suppl.):S259.
    Link to: http://dx.doi.org/10.1016/S0168-8278(17)30827-9
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0168-8278&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000401056600564
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