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Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment
(1) Background: We aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in lung cancer patients treated with tyrosine kinase inhibitor (TKI), particularly in those with resolved HBV infection. (2) Methods: In this retrospective hospital-based cohort study, we screened all lung cancer p...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9820864/ https://www.ncbi.nlm.nih.gov/pubmed/36615034 http://dx.doi.org/10.3390/jcm12010231 |
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author | Lee, Po-Hsin Huang, Yen-Hsiang Hsu, Yu-Wei Chen, Kun-Chieh Hsu, Kuo-Hsuan Lin, Ho Lee, Teng-Yu Tseng, Jeng-Sen Chang, Gee-Chen Yang, Tsung-Ying |
author_facet | Lee, Po-Hsin Huang, Yen-Hsiang Hsu, Yu-Wei Chen, Kun-Chieh Hsu, Kuo-Hsuan Lin, Ho Lee, Teng-Yu Tseng, Jeng-Sen Chang, Gee-Chen Yang, Tsung-Ying |
author_sort | Lee, Po-Hsin |
collection | PubMed |
description | (1) Background: We aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in lung cancer patients treated with tyrosine kinase inhibitor (TKI), particularly in those with resolved HBV infection. (2) Methods: In this retrospective hospital-based cohort study, we screened all lung cancer patients with positive hepatitis B core antibodies (anti-HBc) receiving systemic antineoplastic treatment during the period from January 2011 to December 2020. Cumulative incidences of HBV reactivation, and their hazard ratios (HRs), were evaluated after adjusting patient mortality as a competing risk. (3) Results: Among 1960 anti-HBc-positive patients receiving systemic therapy, 366 were HBsAg-positive and 1594 were HBsAg-negative. In HBsAg-positive patients without prophylactic NUC, 3-year cumulative incidences of HBV reactivation were similar between patients receiving chemotherapy and patients receiving TKI (15.0%, 95% confidence interval (CI): 0–31.2% vs. 21.2%, 95% CI: 10.8–31.7%; p = 0.680). Likewise, 3-year cumulative incidences of HBV-related hepatitis were similar between the two groups (chemotherapy vs. TKI: 15.0%, 95% CI: 0–31.2% vs. 9.3%, 95% CI: 2.8–15.7%; p = 0.441). In 521 HBsAg-negative TKI users, the 3-year cumulative incidence of HBV reactivation was only 0.6% (95% CI: 0.0–1.9%). From multivariable regression analysis, we found that the only independent risk factor for HBV reactivation in TKI users was HBsAg positivity (HR 53.8, 95% CI: 7.0–412.9; p < 0.001). (4) Conclusion: Due to high risks of HBV reactivation in HBsAg-positive TKI users, NUC prophylaxis can be considered. However, in patients with resolved HBV infection, such risks are lower, and therefore regular monitoring is recommended. |
format | Online Article Text |
id | pubmed-9820864 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98208642023-01-07 Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment Lee, Po-Hsin Huang, Yen-Hsiang Hsu, Yu-Wei Chen, Kun-Chieh Hsu, Kuo-Hsuan Lin, Ho Lee, Teng-Yu Tseng, Jeng-Sen Chang, Gee-Chen Yang, Tsung-Ying J Clin Med Article (1) Background: We aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in lung cancer patients treated with tyrosine kinase inhibitor (TKI), particularly in those with resolved HBV infection. (2) Methods: In this retrospective hospital-based cohort study, we screened all lung cancer patients with positive hepatitis B core antibodies (anti-HBc) receiving systemic antineoplastic treatment during the period from January 2011 to December 2020. Cumulative incidences of HBV reactivation, and their hazard ratios (HRs), were evaluated after adjusting patient mortality as a competing risk. (3) Results: Among 1960 anti-HBc-positive patients receiving systemic therapy, 366 were HBsAg-positive and 1594 were HBsAg-negative. In HBsAg-positive patients without prophylactic NUC, 3-year cumulative incidences of HBV reactivation were similar between patients receiving chemotherapy and patients receiving TKI (15.0%, 95% confidence interval (CI): 0–31.2% vs. 21.2%, 95% CI: 10.8–31.7%; p = 0.680). Likewise, 3-year cumulative incidences of HBV-related hepatitis were similar between the two groups (chemotherapy vs. TKI: 15.0%, 95% CI: 0–31.2% vs. 9.3%, 95% CI: 2.8–15.7%; p = 0.441). In 521 HBsAg-negative TKI users, the 3-year cumulative incidence of HBV reactivation was only 0.6% (95% CI: 0.0–1.9%). From multivariable regression analysis, we found that the only independent risk factor for HBV reactivation in TKI users was HBsAg positivity (HR 53.8, 95% CI: 7.0–412.9; p < 0.001). (4) Conclusion: Due to high risks of HBV reactivation in HBsAg-positive TKI users, NUC prophylaxis can be considered. However, in patients with resolved HBV infection, such risks are lower, and therefore regular monitoring is recommended. MDPI 2022-12-28 /pmc/articles/PMC9820864/ /pubmed/36615034 http://dx.doi.org/10.3390/jcm12010231 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lee, Po-Hsin Huang, Yen-Hsiang Hsu, Yu-Wei Chen, Kun-Chieh Hsu, Kuo-Hsuan Lin, Ho Lee, Teng-Yu Tseng, Jeng-Sen Chang, Gee-Chen Yang, Tsung-Ying Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title | Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title_full | Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title_fullStr | Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title_full_unstemmed | Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title_short | Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment |
title_sort | reactivation of hepatitis b virus in lung cancer patients receiving tyrosine kinase inhibitor treatment |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9820864/ https://www.ncbi.nlm.nih.gov/pubmed/36615034 http://dx.doi.org/10.3390/jcm12010231 |
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