HBV Reactivation During the Treatment of Non-Hodgkin Lymphoma and Management Strategies

Xing Cao; Yafei Wang; Panyun Li; Wei Huang; Xiaojuan Lu; Hongda Lu

doi:10.3389/fonc.2021.685706

HBV Reactivation During the Treatment of Non-Hodgkin Lymphoma and Management Strategies

Front Oncol. 2021 Jul 1:11:685706. doi: 10.3389/fonc.2021.685706. eCollection 2021.

Authors

Xing Cao¹, Yafei Wang², Panyun Li¹, Wei Huang¹, Xiaojuan Lu¹, Hongda Lu¹

Affiliations

¹ Department of Oncology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Respiratory and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Abstract

Hepatitis B virus reactivation (HBV-R), which can lead to HBV-related morbidity and mortality, is a common and well-known complication that occurs during the treatment of non-Hodgkin lymphoma (NHL) patients with current or past exposure to HBV infection. HBV-R is thought to be closely associated with chemotherapeutic or immunosuppressive therapies. However, immunosuppressive agents such as anti-CD20 antibodies (e.g., rituximab and ofatumumab), glucocorticoids, and hematopoietic stem cell transplantation (HSCT) administered to NHL patients during treatment can cause deep immunodepression and place them at high risk of HBV-R. In this review, we explore the current evidence, the guidelines of several national and international organizations, and the recommendations of expert panels relating to the definition, risk factors, screening and monitoring strategies, whether to use prophylaxis or pre-emptive therapy, and the optimal antiviral agent and duration of antiviral therapy for HBV-R.

Keywords: antiviral prophylaxis; hepatitis B virus reactivation (HBV-R); immunosuppressive therapy; non-Hodgkin lymphoma (NHL); risk factors; rituximab.

Publication types

Review