Hepatitis B virus reactivation in receiving prophylactic anti-viral therapy for Chinese HBsAg-positive patients of diffuse large B-cell lymphoma: a meta-analysis

作者：Li, Jingjing; Zeng, Qinghai; Liu, Ling; Liu, Chunlan; Wang, Qi; Qin, Jiabi; He, Siqi; Zhu, Yuxing; Zhang, Zhen; Peng, Xiaowei; Zheng, Changli; Zhou, Jianda; Cao, Peiguo; Cao, Ke^*

来源：International Journal of Clinical and Experimental Medicine, 2017, 10(9): 13235-13244.

• Meta-analysis
• HBV
• hepatitis B reactivation
• DLBCL
• non-Hodgkin's lymphoma

Patients with hepatitis B virus (HBV) infection are associated with HBV reactivation without antiviral treatment undergoing conventional chemotherapy. Diffuse large B-cell lymphoma (DLBCL) patients with positive hepatitis B surface antigen (HBsAg) are also high risk. We aim to estimate the risk of HBV reactivation in HBsAg-positive patients receiving prophylactic anti-viral therapy (lamivudine/entecavir) for DLBCL by a systematic review of the English and Chinese language literature. In this study, we found that the rate of HBV reactivation in DLBCL patients with prophylactic anti-viral therapy was remarkably lower than those with no prophylaxis. Risk ratio [RR] was 0.32 (95% CI= 0.19-0.54, I-2= 45.0%, P< 0.00001). Pooled risks of HBV reactivation were also calculated. Data from 826 patients in 13 studies were included. Reactivation rate was estimated at 19.8% (I-2= 44.5%, P< 0.001). Pooled risk of HBV reactivation in HBsAg+ patients receiving CHOP was 17.9% (I-2= 47.6%, P= 0.029), and receiving R-CHOP was 20.7% (I-2= 34.4%, P< 0.001). The HBsAg-positive DLBCL patients with anti-viral prophylaxis during chemotherapy is helpful to prevent HBV reactivation. Our meta-analysis confirms potentially critical risks of HBV reactivation in HBV-carrying DLBCL patients receiving an anti-viral therapy prior to CHOP/R-CHOP chemotherapy.

• 出版日期2017
• 单位中南大学