Hepatitis B reactivation in multiple myeloma patients with resolved hepatitis B undergoing chemotherapy

Ji Yun Lee, Sung Hee Lim, Min Young Lee, Haesu Kim, Dong Hyun Sinn, Geum Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Chul Won Jung, Jun Ho Jang, Won Seog Kim, Seok Jin Kim, Kihyun Kim

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14 Scopus citations

Abstract

Background and Aims: Despite increasing reports of hepatitis B virus (HBV) reactivation in multiple myeloma (MM), HBV reactivation in patients with resolved hepatitis B [hepatitis B surface antigen (HBsAg)-negative/anti-hepatitis B core antigen antibody (anti-HBc)-positive] is still poorly characterized. The aim of this study was to clarify its frequency and risk factors. Methods: A total of 230 MM patients with resolved hepatitis B were retrospectively reviewed for HBV reactivation and biochemical flare. Results: During a median 2.4 years of follow-up, HBV reactivation was diagnosed in 12 patients (5.2%). The cumulative rates of HBV reactivation at 2 years and 5 years were 5% and 8% respectively. A baseline anti-HBs-negative status (P = 0.033) and high-dose therapy/autologous stem-cell transplantation [HDT/ASCT (P = 0.025)] were significant risk factors that were positively associated with HBV reactivation. In subgroup analysis of patients treated with HDT/ASCT (n = 127), a baseline anti-HBs-negative status was the only significant risk factor for HBV reactivation (hazard ratio, 4.64; 95% CI, 1.47-14.7; P = 0.009). Discussion: These data show that evaluation of anti-HBc is needed for MM patients, and suggest that monitoring of HBV DNA should be considered for patients with resolved hepatitis B undergoing HDT/ASCT, especially those who are anti-HBs-negative.

Original languageEnglish
Pages (from-to)2363-2369
Number of pages7
JournalLiver International
Volume35
Issue number11
DOIs
StatePublished - Nov 2015

Keywords

  • Anti-HBc-positive
  • HBsAg-negative
  • Hepatitis B reactivation
  • Multiple myeloma

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    Lee, J. Y., Lim, S. H., Lee, M. Y., Kim, H., Sinn, D. H., Gwak, G. Y., Choi, M. S., Lee, J. H., Jung, C. W., Jang, J. H., Kim, W. S., Kim, S. J., & Kim, K. (2015). Hepatitis B reactivation in multiple myeloma patients with resolved hepatitis B undergoing chemotherapy. Liver International, 35(11), 2363-2369. https://doi.org/10.1111/liv.12838