Antiviral Prophylaxis Cuts Risk of HBV Reactivation With Immune Checkpoint Inhibitors

Hepatitis B virus (HBV) reactivation was rare in patients with antiviral prophylaxis receiving immune checkpoint inhibitor treatment for cancer, according to study findings published online ahead of print in Clinical Gastroenterology and Hepatology.

“However, HBV reactivation may occur in hepatitis B surface antigen-positive patients without antiviral prophylaxis or noncompliant with antiviral prophylaxis,” the researchers advised.

To gauge the risk of HBV reactivation in patients with cancer receiving immune checkpoint inhibitors, researchers looked at data for a historical cohort of 3465 patients treated with immune checkpoint inhibitors between January 2015 and September 2020.

Some 511 patients, or 14.7% of the cohort, showed hepatitis B surface antigen (HBsAg) positivity, according to the study. Incidence rates of HBV reactivation were 0.14% among HBsAg-positive patients and 0% among HBsAg-negative patients.

Among patients who were HBsAg-positive, HBV reactivation occurred at a rate of 0.5% in patients with hepatocellular carcinoma compared with a rate of 2.9% in patients without hepatocellular carcinoma, the study showed. HBV reactivation rates were lower for HBsAg-positive patients with antiviral prophylaxis (0.4%) compared with HBsAg-positive patients without antiviral prophylaxis (6.4%).

“Only 2 patients (0.4%) experienced HBsAg seroclearance after immune checkpoint inhibitor treatment among HBsAg-positive patients,” researchers reported.

—Jolynn Tumolo

Reference

Yoo S, Lee D, Shim JH, et al. Risk of hepatitis B virus reactivation in patients treated with immunotherapy for anti-cancer treatment. Clinical Gastroenterology and Hepatology. 2021 June 26;[Epub ahead of print].