Hepatitis B virus management to prevent reactivation after chemotherapy: a review.
Hepatitis B virus management to prevent reactivation after chemotherapy: a review.
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DOI：
10.1007/s00520-012-1576-7
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发表时间：
2012-11
影响因子：
3.1
通讯作者：
Loomba, Rohit
中科院分区：
文献类型：
--
作者：
Hwang, Jessica P.;Vierling, John M.;Zelenetz, Andrew D.;Lackey, Susan C.;Loomba, Rohit
化疗后B型肝炎病毒（HBV）感染的再激活可导致肝功能衰竭和死亡。在等待化疗的癌症患者中进行HBV筛查的建议意味着一些有HBV再激活风险的患者没有被发现并接受预防性抗病毒治疗。我们使用奥维德Medline、PubMed和科克伦图书馆对现有的关于癌症患者HBV感染筛查和管理的证据进行了叙述性回顾。我们的综述显示，HBV再激活的定义和管理策略不一致。再激活的时间范围是可变的，其分子机制尚不清楚。有五种有效的抗病毒药物可用于预防癌症患者HBV感染的再激活;然而，最佳药物和治疗持续时间尚不清楚。在接受利妥昔单抗治疗的血液恶性肿瘤患者中，再激活更常见，但在其他化疗后和实体瘤患者中也可能发生再激活。筛查与所有三个筛查测试-HBsAg，抗-HBc，抗-HBs-允许最彻底的解释患者的血清学资料和评估的再激活风险，但是，决策和成本效益的研究，需要确定最佳的筛查策略。预防乙型肝炎病毒感染重新激活取决于识别高危患者并启动抗病毒预防，但缺乏指导筛查和治疗策略的数据。进一步的研究是必要的，以准确地定义和预测再激活，确定最佳的抗病毒治疗策略，并确定具有成本效益的HBV筛查策略。
Reactivation of hepatitis B virus (HBV) infection after chemotherapy can lead to liver failure and death. Conflicting recommendations regarding HBV screening in cancer patients awaiting chemotherapy mean that some patients at risk for HBV reactivation are not being identified and treated with prophylactic antiviral therapy. We performed a narrative review of the existing evidence regarding screening for and management of HBV infection among patients with cancer using Ovid Medline, PubMed, and the Cochrane Library. Our review showed inconsistencies in the definition and management strategies for HBV reactivation. The timeframe of reactivation is variable, and its molecular mechanisms are not clear. There are five effective antiviral agents that can be used as prophylaxis to prevent reactivation of HBV infection in cancer patients; however, the optimal drug and duration of therapy are unknown. Reactivation is more commonly reported in patients with hematologic malignancies receiving rituximab treatment, but reactivation can occur after other chemotherapies and in patients with solid tumors. Screening with all three screening tests—HBsAg, anti-HBc, and anti-HBs—allows the most thorough interpretation of a patient’s serologic profile and assessment of reactivation risk; however, decision-making and cost-effectiveness studies are needed to determine optimal screening strategies. Prevention of reactivation of HBV infection depends on identification of patients at risk and initiation of antiviral prophylaxis, but data to guide screening and treatment strategies are lacking. Additional research is necessary to accurately define and predict reactivation, identify best antiviral treatment strategies, and identify cost-effective HBV screening strategies.
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影响因子：
8.8
作者：
Cheung, Wing-I.;Chan, Henry Lik-Yuen;Chau, Tai-Nin
通讯作者：
Chau, Tai-Nin
影响因子：
6.7
作者：
Ferraro, Donatella;Pizzillo, Paola;Di Stefano, Rosa
通讯作者：
Di Stefano, Rosa
影响因子：
8.8
作者：
Cortelezzi, Agostino;Vigano, Mauro;Lampertico, Pietro
通讯作者：
Lampertico, Pietro
影响因子：
13.5
作者：
Cheng, AL;Hsiung, CA;Whang-Peng, J
通讯作者：
Whang-Peng, J
影响因子：
3.6
作者：
Aomatsu, Tomoki;Komatsu, Haruki;Tamai, Hiroshi
通讯作者：
Tamai, Hiroshi