HBsAg-negative/anti-HBc-positive patients treated with rituximab: prophylaxis or monitoring to prevent hepatitis B reactivation?

Infection. 2019 Apr;47(2):293-300. doi: 10.1007/s15010-019-01271-z. Epub 2019 Jan 28.


Rituximab (RTX) has been classified as a drug associated with a high risk for hepatitis B virus (HBV) reactivation in HbsAg-negative/anti-HBc-positive patients. However, data on frequency of HBV reactivation are limited especially for RTX monotherapy. Several new recommendations for screening, monitoring and prophylactic antiviral treatment have been published recently. Here, we report the real-life experience in the management and reactivation rate of HbsAg-negative/anti-HBc-positive patients treated with RTX with or without chemotherapy from a large cohort and discuss our results in the light of updated recommendations.

Keywords: Autoimmune diseases; Hematologic diseases; Hepatitis B; Monotherapy; Reactivation; Risk groups; Rituximab.

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / therapeutic use*
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Germany
  • Hepatitis B / drug therapy*
  • Hepatitis B / virology
  • Hepatitis B Core Antigens / immunology
  • Hepatitis B Surface Antigens / immunology
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / physiology
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rituximab / therapeutic use*
  • Virus Activation / drug effects*


  • Antirheumatic Agents
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens
  • Rituximab