國家衛生研究院 NHRI:Item 3990099045/11092
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    題名: Quantification of HBV core antibodies may help predict HBV reactivation in patients with lymphoma and resolved HBV infection
    作者: Yang, HC;Tsou, HH;Pei, SN;Chang, CS;Chen, JH;Yao, M;Lin, SJ;Lin, J;Yuan, Q;Xia, N;Liu, TW;Chen, PJ;Cheng, AL;Hsu, C;Taiwan Cooperative Oncology Group
    貢獻者: Institute of Population Health Sciences;National Institute of Cancer Research
    摘要: BACKGROUND AND AIMS: Absence or low anti-hepatitis B (HBV) surface antibody (anti-HBs) is associated with increased risk of HBV reactivation in lymphoma patients with resolved HBV infection receiving rituximab-containing chemotherapy. Quantification of anti-HBV core antibody (anti-HBc) is a new marker associated with the natural history and treatment response of chronic HBV infection. This study investigated whether baseline anti-HBc and anti-HBs levels may better predict HBV reactivation. METHODS: We prospectively measured the HBV DNA levels of lymphoma patients with resolved HBV infection receiving rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy and started antiviral therapy upon HBV reactivation, defined as a greater than 10-fold increase in HBV DNA compared with previous nadir levels. Anti-HBs and anti-HBc were quantified by a double-sandwich assay. Receiver operating characteristic curve analysis was used to determine optimal baseline anti-HBc/ anti-HBs levels for predicting HBV reactivation. RESULTS: HBV reactivation occurred to 24 of the 197 patients enrolled, with an incidence of 11.6 per 100 person-year. For the 192 patients with enough serum samples for analysis, low anti-HBs (<56.48 mIU/mL) and high anti-HBc (>=6.41 IU/mL) at baseline were significantly associated with high risk of HBV reactivation (hazard ratio (HR) 8.48 and 4.52, respectively, p<0.01). Multivariate analysis indicated that (1) patients with both high anti-HBc and low anti-HBs at baseline (36 of 192 patients) had a HR of 17.29 for HBV reactivation (95% confidence interval (95% C.I.) 3.92-76.30, p<0.001); (2) HBV reactivation may be associated with inferior overall survival (HR 2.41, 95% C.I. 1.15-5.05, p=0.02). CONCLUSIONS: Baseline anti-HBc/ anti-HBs levels may predict HBV reactivation in these lymphoma patients and help optimize prophylactic antiviral therapy for the high-risk patients. LAY SUMMARY: In this study we identified a subgroup of patients with lymphoma and resolved HBV infection who had high risk of HBV reactivation after receiving rituximab-containing chemotherapy. These findings will help optimize preventive strategy, especially in HBV-endemic regions with limited health resources.
    日期: 2018-08
    關聯: Journal of Hepatology. 2018 Aug;69(2):286-292.
    Link to: http://dx.doi.org/10.1016/j.jhep.2018.02.033
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0168-8278&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000438753600006
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85046163058
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