Risk for HBV Reactivation With and Without Prophylaxis During Solid Tumor Chemotherapy

We know that hepatitis B virus (HBV) reactivation is a risk of chemotherapy, particularly with rituximab-based regimens. In the current systematic review and meta-analysis, investigators quantified the risk for HBV reactivation with and without HBV prophylaxis in patients with chronic and resolved HBV infection undergoing chemotherapy for solid tumors. HBV reactivation was defined as reemergence of hepatitis B surface antigen (HBsAg; in resolved infections), an absolute increase in HBV DNA >10⁵ copies/mL, or a >10-fold increase in HBV DNA from baseline.

Of 26 observational and randomized, controlled studies included, 23 studies involved patients with chronic infection and 3 with resolved infection. The absolute risk for HBV reactivation in p…