Screening for Chronic Hepatitis B Virus Infection in Patients With Malignancies and Assessment of the Impact of Malignancies on the Response To Preemptive Treatment of Chronic Hepatitis B Virus

ABSTRACT

The prevalence of hepatitis B virus (HBV) infection in patients with malignancies especially haematological malignancies is increased compared with the general population worldwide. HBV reactivation is common following chemotherapy and is associated with a high mortality despite prompt anti-viral treatment. HBV reactivation may necessitate interruption of chemotherapy with adverse prognostic consequences for the haematological disease. All candidates for chemotherapy and immunosuppressive therapy should be tested for HBV markers prior to immunosuppression, All HBsAg-positive patients should receive ETV or TDF or TAF as treatment or prophylaxis, HBsAg-negative, anti-HBc positive subjects should receive anti-HBV prophylaxis if they are at high risk of HBV reactivation according to EASL guidelines 2017. The aim of this study was to screen for chronic Hepatitis B virus infection in patients with Malignancies recruited from Oncology department in Main Alexandria University Hospital and assessment of the impact of malignancy on the response to preemptive treatment of chronic Hepatitis B virus with Nucleoside analogue (Entecavir 0.5mg). The study was conducted on 500 patients recruited from Oncology department screened for CHB virus infection and those who suffered from CHB were called group I and treated with Entecavir 0.5mg tab and treatment response was compared to group II patients which included 20 control patients suffering from chronic Hepatitis B virus being treated with Nucleoside analogue (Entecavir 0.5mg). In both groups 100% patients was successfully treated with Entecavir 0.5mg tab daily and all the patients met the criteria of virological response to treatment (undetectable PCR after 6 months of treatment) and no virological breakthrough or treatment failure was reported. Also there was statistically significant reduction in AST, ALT, Total and Direct bilirubin levels in both groups with Entecavir 0.5mg tab treatment daily. Percentage of patients suffering from chronic HBV in Oncology department at Alexandria Main University Hospital is 4.6 % and the effectiveness of Entecavir 0.5mg tab in treatment of chronic HBV in patients with malignancies is comparable to patients without malignancies.

Keywords: Hepatitis B virus, Preemptive treatment, Entecavir, Malignancies.     

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