Dataset Information

Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab.

ABSTRACT:

Objective

Hepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in light of recommendations.

Design

Retrospective, observational study.

Setting

Single, tertiary care centre in the USA.

Participants

Patients receiving rituximab from January 2005 to December 2017.

Primary outcome

Trends of hepatitis B screening prior to initiation of rituximab.

Secondary outcome

Results of hepatitis B screening, use of preventive NA therapy and HBr incidence.

Results

Over 13 years, 2219 patients received rituximab. Screening, with at least hepatitis B core antibody (anti-HBc) prior to the first dose of rituximab, improved from 20% to 97%. Because only 4.5% of patients had a positive anti-HBc, the overall HBr incidence was very low (0.42%). In susceptible patients, the incidence of HBr was 8%. In at-risk patients given preventive NA, 96% remained free of HBr. However, only 23% received a preventive NA and no temporal improvement in compliance was seen. Of those with HBr, 87.5% were hepatitis B surface antigen (HbsAg-)/anti-HBc+.

Conclusions

In those treated with rituximab, we demonstrated near-universal anti-HBc screening. Screening unlinked to preventive NA use, in those who are anti-HBc+, is ineffective in reducing HBr. HBr has a high fatality rate. The majority of cases occurred in those who were HBsAg negative. Efforts are needed to educate providers who use rituximab not only to screen for anti-HBc, but to provide preventive NA to those who test positive.

SUBMITTER: Haider M

PROVIDER: S-EPMC7745525 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab.

Haider Mahnur M Haider Mahnur M Flocco Gianina G Lopez Rocio R Carey William W

BMJ open 20201215 12

<h4>Objective</h4>Hepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in light of recommendations.<h4>Design</h4>Retrospective, observational study.<h4>Setting</h4>Single, tertiary care centre in the USA.<h4>Participants</h4>Patients receiving rit ...[more]

PMID: 33323450

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Dataset Information

Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab.

Objective

Design

Setting

Participants

Primary outcome

Secondary outcome

Results

Conclusions

Publications

Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab.

Similar Datasets

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