Ahmed Azzam, Heba Khaled, Basem Osama Ashry, Sarah Mohamed Hussein, Manar Osama, Ameer Ahmed, Omar Yousef, Anees Hjazeen, Ahmed A. Allam, Gellan Alaa Mohamed Kamel
{"title":"接受布鲁顿酪氨酸激酶抑制剂（BTKIs）治疗的患者中的 HBV 再激活：系统回顾和 Meta 分析","authors":"Ahmed Azzam, Heba Khaled, Basem Osama Ashry, Sarah Mohamed Hussein, Manar Osama, Ameer Ahmed, Omar Yousef, Anees Hjazeen, Ahmed A. Allam, Gellan Alaa Mohamed Kamel","doi":"10.1007/s11908-023-00827-3","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose of Review</h3><p>Bruton tyrosine kinase inhibitors (BTKIs) are immunosuppressive cancer therapies approved for the treatment of various mature B-cell malignancies. Hepatitis B virus reactivation (HBVr) is a known complication in patients with chronic or past HBV infection undergoing immunosuppressive chemotherapy. The present work aims to establish the correlation between HBVr and patients receiving BTKIs.</p><h3 data-test=\"abstract-sub-heading\">Recent Findings</h3><p>This review included 18 studies. The overall incidence of HBVr was found to be 6.6% in patients with past HBV infections who received ibrutinib. Fourteen cases of HBVr were associated with ibrutinib (two occult hepatitis B infections and twelve past HBV infections). One case of HBV past infection was associated with zanubrutinib, and three cases were recorded for acalabrutinib (one chronic HBV and two past HBV). Most incidents occurred in males older than 60 years within the first year after initiating BTKIs. Three reported cases documented HBVr after discontinuing ibrutinib and zanubrutinib. Two deaths caused by HBVr in patients with past HBV infections were recorded (one for each of acalabrutinib and ibrutinib). Remarkably, HBV antiviral treatment normalized liver functions and eliminated serum HBV in most cases. It was reported that false negativity of HBsAg following reactivation occurred in two cases: one case was attributed to HBsAg escape mutations, and the other to the hook effect.</p><h3 data-test=\"abstract-sub-heading\">Summary</h3><p>Our findings show that HBVr risk is intermediate in patients with past HBV infections who receive ibrutinib. Universal anti-HBV prophylaxis before initiating ibrutinib may be an option.</p>","PeriodicalId":48839,"journal":{"name":"Current Infectious Disease Reports","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"HBV Reactivation in Patients Receiving Bruton Tyrosine Kinase Inhibitors (BTKIs): a Systematic Review and Meta-Analysis\",\"authors\":\"Ahmed Azzam, Heba Khaled, Basem Osama Ashry, Sarah Mohamed Hussein, Manar Osama, Ameer Ahmed, Omar Yousef, Anees Hjazeen, Ahmed A. Allam, Gellan Alaa Mohamed Kamel\",\"doi\":\"10.1007/s11908-023-00827-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose of Review</h3><p>Bruton tyrosine kinase inhibitors (BTKIs) are immunosuppressive cancer therapies approved for the treatment of various mature B-cell malignancies. Hepatitis B virus reactivation (HBVr) is a known complication in patients with chronic or past HBV infection undergoing immunosuppressive chemotherapy. The present work aims to establish the correlation between HBVr and patients receiving BTKIs.</p><h3 data-test=\\\"abstract-sub-heading\\\">Recent Findings</h3><p>This review included 18 studies. The overall incidence of HBVr was found to be 6.6% in patients with past HBV infections who received ibrutinib. Fourteen cases of HBVr were associated with ibrutinib (two occult hepatitis B infections and twelve past HBV infections). One case of HBV past infection was associated with zanubrutinib, and three cases were recorded for acalabrutinib (one chronic HBV and two past HBV). Most incidents occurred in males older than 60 years within the first year after initiating BTKIs. Three reported cases documented HBVr after discontinuing ibrutinib and zanubrutinib. Two deaths caused by HBVr in patients with past HBV infections were recorded (one for each of acalabrutinib and ibrutinib). Remarkably, HBV antiviral treatment normalized liver functions and eliminated serum HBV in most cases. It was reported that false negativity of HBsAg following reactivation occurred in two cases: one case was attributed to HBsAg escape mutations, and the other to the hook effect.</p><h3 data-test=\\\"abstract-sub-heading\\\">Summary</h3><p>Our findings show that HBVr risk is intermediate in patients with past HBV infections who receive ibrutinib. 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HBV Reactivation in Patients Receiving Bruton Tyrosine Kinase Inhibitors (BTKIs): a Systematic Review and Meta-Analysis
Purpose of Review
Bruton tyrosine kinase inhibitors (BTKIs) are immunosuppressive cancer therapies approved for the treatment of various mature B-cell malignancies. Hepatitis B virus reactivation (HBVr) is a known complication in patients with chronic or past HBV infection undergoing immunosuppressive chemotherapy. The present work aims to establish the correlation between HBVr and patients receiving BTKIs.
Recent Findings
This review included 18 studies. The overall incidence of HBVr was found to be 6.6% in patients with past HBV infections who received ibrutinib. Fourteen cases of HBVr were associated with ibrutinib (two occult hepatitis B infections and twelve past HBV infections). One case of HBV past infection was associated with zanubrutinib, and three cases were recorded for acalabrutinib (one chronic HBV and two past HBV). Most incidents occurred in males older than 60 years within the first year after initiating BTKIs. Three reported cases documented HBVr after discontinuing ibrutinib and zanubrutinib. Two deaths caused by HBVr in patients with past HBV infections were recorded (one for each of acalabrutinib and ibrutinib). Remarkably, HBV antiviral treatment normalized liver functions and eliminated serum HBV in most cases. It was reported that false negativity of HBsAg following reactivation occurred in two cases: one case was attributed to HBsAg escape mutations, and the other to the hook effect.
Summary
Our findings show that HBVr risk is intermediate in patients with past HBV infections who receive ibrutinib. Universal anti-HBV prophylaxis before initiating ibrutinib may be an option.
期刊介绍：
This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of infectious disease.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as HIV/AIDS, sexually transmitted diseases, tropical and travel medicine, and urinary tract infections. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists.
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