Monitoring of Hepatitis B Virus (HBV) DNA and Risk of HBV Reactivation in B-Cell Lymphoma: A Prospective Observational Study

被引：128

作者：

Kusumoto, Shigeru ^{[1
]}

Tanaka, Yasuhito ^{[2
,3
]}

Suzuki, Ritsuro ^{[4
]}

Watanabe, Takashi ^{[5
]}

Nakata, Masanobu ^{[6
]}

Takasaki, Hirotaka ^{[7
]}

Fukushima, Noriyasu ^{[8
]}

Fukushima, Takuya ^{[9
]}

Moriuchi, Yukiyoshi ^{[10
]}

Itoh, Kuniaki ^{[11
]}

Nosaka, Kisato ^{[12
]}

Choi, Ilseung ^{[13
]}

Sawa, Masashi ^{[14
]}

Okamoto, Rumiko ^{[15
]}

Tsujimura, Hideki ^{[16
]}

Uchida, Toshiki ^{[17
]}

Suzuki, Sachiko ^{[18
]}

Okamoto, Masataka ^{[19
]}

Takahashi, Tsutomu ^{[20
]}

Sugiura, Isamu ^{[21
]}

Onishi, Yasushi ^{[22
]}

Kohri, Mika ^{[23
]}

Yoshida, Shinichiro ^{[24
]}

Sakai, Rika ^{[25
]}

Kojima, Minoru ^{[26
]}

Takahashi, Hiroyuki ^{[27
]}

Tomita, Akihiro ^{[28
]}

Maruyama, Dai ^{[5
]}

Atsuta, Yoshiko ^{[4
]}

Tanaka, Eiji ^{[29
]}

Suzuki, Takayo ^{[30
]}

Kinoshita, Tomohiro ^{[31
]}

Ogura, Michinori ^{[17
]}

Mizokami, Masashi ^{[32
]}

Ueda, Ryuzo ^{[33
]}

机构：

[1] Nagoya City Univ, Grad Sch Med Sci, Dept Hematol & Oncol, Nagoya, Aichi, Japan

[2] Nagoya City Univ, Grad Sch Med Sci, Dept Virol, Nagoya, Aichi, Japan

[3] Nagoya City Univ, Grad Sch Med Sci, Liver Unit, Nagoya, Aichi, Japan

[4] Nagoya City Univ, Grad Sch Med Sci, Dept Hematopoiet Stem Cell Transplantat Data Mana, Nagoya, Aichi, Japan

[5] Natl Canc Ctr, Dept Hematol, Tokyo, Japan

[6] Sapporo Hokuyu Hosp, Dept Internal Med, Sapporo, Hokkaido, Japan

[7] Kanagawa Canc Ctr, Dept Med Oncol, Yokohama, Kanagawa 2410815, Japan

[8] Saga Univ, Fac Med, Dept Internal Med, Div Hematol, Saga, Japan

[9] Nagasaki Univ, Atom Bomb Dis Inst, Atom Bomb Dis & Hibakusha Med Unit, Dept Hematol, Nagasaki, Japan

[10] Sasebo City Gen Hosp, Dept Hematol, Sasebo, Japan

[11] Natl Canc Ctr Hosp East, Div Hematol & Oncol, Kashiwa, Chiba, Japan

[12] Kumamoto Univ, Sch Med, Dept Hematol & Infect Dis, Kumamoto 860, Japan

[13] Natl Hosp Org, Kyushu Canc Ctr, Div Hematol, Fukuoka, Japan

[14] Anjo Kosei Hosp, Dept Hematol & Oncol, Anjo, Aichi, Japan

[15] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Chemotherapy, Tokyo, Japan

[16] Chiba Canc Ctr, Div Hematol Oncol, Chiba, Japan

[17] Nagoya Daini Red Cross Hosp, Dept Hematol & Oncol, Nagoya, Aichi, Japan

[18] Natl Hosp Org, Hokkaido Canc Ctr, Dept Hematol, Sapporo, Hokkaido, Japan

[19] Fujita Hlth Univ, Sch Med, Dept Hematol & Med Oncol, Toyoake, Aichi 47011, Japan

[20] Shimane Univ Hosp, Dept Oncol Hematol, Izumo, Shimane, Japan

[21] Toyohashi Municipal Hosp, Div Hematol & Oncol, Toyohashi, Aichi, Japan

[22] Tohoku Univ Hosp, Dept Hematol & Rheumatol, Sendai, Miyagi, Japan

[23] Saitama Med Univ, Int Med Ctr, Dept Hematol, Hidaka, Japan

[24] Natl Hosp Org, Nagasaki Med Ctr, Dept Hematol, Ohmura, Japan

[25] Yokohama City Univ, Med Ctr, Dept Hematol, Yokohama, Kanagawa, Japan

[26] Tokai Univ, Sch Med, Dept Hematol & Oncol, Isehara, Kanagawa 25911, Japan

[27] Yokohama City Univ, Grad Sch Med, Dept Internal Med & Clin Immunol, Yokohama, Kanagawa, Japan

[28] Nagoya Univ, Grad Sch Med, Dept Hematol & Oncol, Nagoya, Aichi 4648601, Japan

[29] Shinshu Univ, Sch Med, Dept Med, Matsumoto, Nagano 390, Japan

[30] Shiga Med Ctr Adults, Dept Hematol & Oncol, Moriyama, Japan

[31] Aichi Canc Ctr Hosp, Dept Hematol & Cell Therapy, Nagoya, Aichi 464, Japan

[32] Natl Ctr Global Hlth & Med, Res Ctr Hepatitis & Immunol, Ichikawa, Japan

[33] Aichi Med Univ, Sch Med, Dept Tumor Immunol, Nagoya, Aichi, Japan

来源：

CLINICAL INFECTIOUS DISEASES | 2015年 / 61卷 / 05期

关键词：

HBV DNA monitoring; HBV reactivation; resolved HBV infection; rituximab; preemptive antiviral therapy; RANDOMIZED CONTROLLED-TRIAL; CYTOTOXIC CHEMOTHERAPY; RECEIVING RITUXIMAB; MALIGNANT-LYMPHOMA; INFECTION; LAMIVUDINE; THERAPY; PATIENT; IMMUNOGENICITY; PROPHYLAXIS;

D O I：

10.1093/cid/civ344

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. There is no standard management of reactivation of hepatitis B virus (HBV) infection in HBV-resolved patients without hepatitis B surface antigen (HBsAg), but with antibodies against hepatitis B core antigen and/or antibodies against HBsAg (anti-HBs). Methods. We conducted a prospective observational study to evaluate the occurrence of HBV reactivation by serial monthly monitoring of HBV DNA and to establish preemptive therapy guided by this monitoring in B-cell non-Hodgkin lymphoma (B-NHL) treated with rituximab plus corticosteroid-containing chemotherapy (R-steroid-chemo). The primary endpoint was the incidence of HBV reactivation defined as quantifiable HBV DNA levels of >= 11 IU/mL. Results. With a median HBV DNA follow-up of 562 days, HBV reactivation was observed in 21 of the 269 analyzed patients. The incidence of HBV reactivation at 1.5 years was 8.3% (95% confidence interval, 5.5-12.4). No hepatitis due to HBV reactivation was observed in patients who received antiviral treatment when HBV DNA levels were between 11 and 432 IU/mL. An anti-HBs titer of <10 mIU/mL and detectable HBV DNA remaining below the level of quantification at baseline were independent risk factors for HBV reactivation (hazard ratio, 20.6 and 56.2, respectively; P < .001). Even in 6 patients with a rapid increase of HBV due to mutations, the monthly HBV DNA monitoring was effective at preventing HBV-related hepatitis. Conclusions. Monthly monitoring of HBV DNA is useful for preventing HBV reactivation-related hepatitis among B-NHL patients with resolved HBV infection following R-steroid-chemo (UMIN000001299).

引用

页码：719 / 729

页数：11

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