Screening for viral hepatitis B infection in cancer patients before receiving chemotherapy – A systematic review and meta-analysis

IF 1.4 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2024-03-21 DOI:10.1111/ajco.14055

Soe Thiha Maung, Natee Deepan, Pakanat Decharatanachart, Roongruedee Chaiteerakij

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Abstract

Aim

We conducted a systematic review and meta-analysis to assess the hepatitis B virus (HBV) screening rate in cancer patients before systemic chemotherapy, aiming to identify those needing antiviral prophylaxis for HBV reactivation.

Methods

We searched PubMed, Embase, Scopus, and Google Scholar for relevant studies. The pooled screening rate was estimated using a random effects model. Subgroup analyses were conducted based on malignancy types, chemotherapy regimens, study period, and HBV endemic regions.

Results

The meta-analysis included 29 studies from various endemic regions (19 low-endemic, three lower intermediate-endemic, and seven higher intermediate-endemic). These studies encompassed hematologic malignancies (n = 10), solid-organ tumors (n = 4), and combinations (n = 15). Seven studies used rituximab-containing regimens, four did not, and the remaining 11 did not specify chemotherapy regimens. The pooled screening rate was 57% (95% confidence interval [95%CI]: 46%–68%, I²= 100%). Over time, screening rates improved from 37% (95%CI: 23%–53%) in 2006–2010 to 68% (54%–80%) in 2011–2015 and 69% (48%–84%) in 2016–2020. Screening rates were highest at 89% (74%–96%) in high endemic countries, followed by 60% (45–73%) in lower-intermediate and 49% (34–64%) in low-endemic countries. Patients with hematological malignancies had a higher screening rate than those with solid organ tumors, 65% (55%–74%) versus 37% (21%–57%), respectively. A screening rate was higher in patients receiving rituximab-containing chemotherapy than non-rituximab regimens, 68% (55%–79%) versus 45% (27%–65%).

Conclusion

Despite existing guidelines, pre-chemotherapy HBV screening rate remains unsatisfactory, with substantial heterogeneous rates globally. These findings underscore the need for effective strategies to align practices with clinical guidelines.

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癌症患者接受化疗前的乙型病毒性肝炎感染筛查 - 系统回顾和荟萃分析。

目的：我们进行了一项系统性综述和荟萃分析，以评估全身化疗前癌症患者的乙型肝炎病毒（HBV）筛查率，目的是确定那些需要抗病毒预防HBV再激活的患者：我们检索了 PubMed、Embase、Scopus 和 Google Scholar 上的相关研究。采用随机效应模型估算了汇总筛查率。根据恶性肿瘤类型、化疗方案、研究时间和 HBV 流行地区进行了分组分析：荟萃分析包括来自不同流行地区的 29 项研究（19 项低度流行、3 项中度流行、7 项中度流行以上）。这些研究包括血液系统恶性肿瘤（10 项）、实体器官肿瘤（4 项）和混合瘤（15 项）。7 项研究使用了含利妥昔单抗的方案，4 项未使用，其余 11 项未明确说明化疗方案。汇总筛查率为 57%（95% 置信区间 [95%CI]：46%-68%，I2 = 100%）。随着时间的推移，筛查率从2006-2010年的37%（95%CI：23%-53%）提高到2011-2015年的68%（54%-80%）和2016-2020年的69%（48%-84%）。高流行率国家的筛查率最高，为 89% (74%-96%)，其次是中低流行率国家的 60% (45%-73%)和低流行率国家的 49% (34%-64%)。血液恶性肿瘤患者的筛查率高于实体器官肿瘤患者，分别为 65%（55%-74%）和 37%（21%-57%）。接受含利妥昔单抗化疗的患者筛查率高于未接受利妥昔单抗化疗的患者，分别为68%（55%-79%）和45%（27%-65%）：尽管已有相关指南，但化疗前的 HBV 筛查率仍不尽如人意，全球范围内的筛查率存在很大差异。这些研究结果表明，有必要采取有效策略，使临床实践与临床指南保持一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.