Hepatitis B reactivation in patients receiving targeted therapies
Hepatitis B reactivation in patients receiving targeted therapies
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DOI：
10.1080/10245332.2017.1321882
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发表时间：
2017-01-01
期刊：
影响因子：
1.9
通讯作者：
Yan, Sheng-Lei
中科院分区：
文献类型：
--
作者：
Chang, Cheng-Shyong;Tsai, Chien-Yu;Yan, Sheng-Lei
目的：B型肝炎病毒（HBV）再激活可能自发发生，在抗病毒治疗期间或之后，或接受免疫抑制化疗时。在接受靶向治疗（如单克隆抗体和哺乳动物雷帕霉素靶点（mTOR）抑制剂）的癌症患者中也报告了HBV再活化。本文旨在讨论接受靶向治疗的患者中慢性HBV再激活的问题，特别关注酪氨酸激酶抑制剂。方法：使用MEDLINE检索与B肝炎再激活、单克隆抗体治疗和酪氨酸激酶抑制剂相关的文献。结果：接受酪氨酸激酶抑制剂（TKI）治疗的HBV感染患者即使HBV感染状态已消退，也可能发生HBV再激活。虽然TKI诱导的HBV再激活的确切机制尚不清楚，脱靶的TKI免疫效应可能发挥重要作用，有助于HBV reactivation.Discussion：进一步精心设计的研究是必要的，以找出HBV再激活的发病率和机制，在接受TKI的患者。筛查，监测和预防或先发制人的抗病毒治疗是强制性的HBV患者谁是要接受免疫抑制剂治疗或靶向therapy.Conclusion：HBV再激活可能发生在接受单克隆抗体和TKI的患者，即使解决HBV感染状态。尽管TKI诱导HBV再活化的确切机制尚不清楚，但TKI的脱靶免疫效应可能在促成HBV再活化方面发挥重要作用。
Objectives: Hepatitis B virus (HBV) reactivation may occur spontaneously, during or after antiviral therapy, or when receiving immunosuppressive chemotherapy. HBV reactivation has also been reported in cancer patients receiving targeted therapies, such as monoclonal antibody and mammalian target of rapamycin (mTOR) inhibitor. This review article is aimed to discuss the issue regarding chronic HBV reactivation in patients receiving targeted therapies, with a special focus on tyrosine kinase inhibitors.Methods: Using MEDLINE search, the literature relevant to hepatitis B reactivation, monoclonal antibody therapy and tyrosine kinase inhibitor was reviewed.Results: HBV-infected patients receiving tyrosine kinase inhibitors (TKIs) may develop HBV reactivation even with resolved HBV infection status. Although the exact mechanism of TKI-induced HBV reactivation remains unclear, off-target immunological effects of TKI may play an important role in contributing to HBV reactivation.Discussion: Further well-designed studies are necessary to find out the incidence and mechanism of HBV reactivation in patients receiving TKIs. Screening, monitoring and prophylaxis or pre-emptive antiviral therapy is mandatory in HBV patients who are going to receive immunosuppressive therapy or targeted therapy.Conclusion: HBV reactivation may occur in patients receiving monoclonal antibodies and TKIs, even with resolved HBV infection status. Although the exact mechanism of TKI-induced HBV reactivation remains unclear, off-target immunological effects of TKI may play an important role in contributing to HBV reactivation.