Hepatitis B virus reactivation after withdrawal of prophylactic antiviral therapy in patients with diffuse large B cell lymphoma

Abstract

The exact incidence and severity of hepatitis B virus (HBV) reactivation after the withdrawal of prophylactic antiviral therapy (delayed HBV reactivation) is unknown. We retrospectively analyzed 107 newly diagnosed diffuse large B cell lymphoma patients with HBV infection who received chemotherapy. The median time from the cessation of antitumor therapy to the withdrawal of prophylactic antiviral therapy was 6.1 months. The incidence of delayed HBV reactivation was 21.7% in HBsAg-positive group and 0 in HBsAg-negative/anti-HBc-positive group (P < 0.001). No HBV-related fulminant hepatitis or hepatitis-related death occurred. The multivariate analysis showed that female gender and lengthy cycles of chemotherapy (>8 cycles) were independent risk factors of HBV reactivation in HBsAg-positive patients. In conclusion, prophylactic antiviral therapy could be withdrawn 6 months after the cessation of chemotherapy in HBsAg-negative/anti-HBc-positive patients. However, a longer course of prophylactic antiviral drug administration may be an optimal option to prevent delayed HBV reactivation for HBsAg-positive patients.

Keywords:

• hepatitis B
• lymphoma
• drug therapy
• treatment outcome
• survival analysis

Acknowledgments

This work was supported by K12 HL097064 and AA & MDS International Foundation Research Grant to D.B., NCI/NIH R01 CA105312, Buck Family Endowed Chair in Hematology, and R24 DK103001 to MB, and the American Society of Hematology Scholar Award and the K08 HL122306 to T.O.

Potential conflict of interest

Support was provided by the National Natural Science Foundation of China (Grant No. 81241073) and Peking University Cancer Hospital Foundation for Scientific Research (Grant No. 2013-Autonomous-9). Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1116121.