Efficient Prophylactic Management of HBV Reactivation by an Information Technology Encoding System: Results of a 6-year Prospective Cohort Study

Autor: Hiroyuki Watanabe, Akihiro Tanaka, Taku Sanada, Kazuo Notsumata, Teruyuki Ueda, Daisyu Toya, Yoshimoto Nomura, Yoshikatsu Nomura
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
030204 cardiovascular system & hematology
Gastroenterology
0302 clinical medicine
rituximab
Risk Factors
Prospective Studies
Prospective cohort study
Aged
80 and over

biology
Immunosuppression
General Medicine
Hepatitis C
Hepatitis B
Middle Aged
Rheumatoid arthritis
medical information coding
030211 gastroenterology & hepatology
Rituximab
Original Article
Female
Steroids
Antibody
Information Technology
Immunosuppressive Agents
medicine.drug
Adult
medicine.medical_specialty
Hepatitis B virus
HBV reactivation
Antineoplastic Agents
Antiviral Agents
03 medical and health sciences
Immunocompromised Host
Young Adult
Internal medicine
Internal Medicine
medicine
Humans
immunosuppression/chemotherapy
Hepatitis B Antibodies
Aged
Chemotherapy
business.industry
Hepatitis C
Chronic

medicine.disease
biology.protein
Virus Activation
business
Zdroj: Internal Medicine
ISSN: 1349-7235
0918-2918
Popis: Objective We started an information technology (IT) system that encodes the medical treatment status of hepatitis B virrus (HBV) with a 9-digit number, automatically checks for inappropriate situations occurring due to immunosuppression and chemotherapy that do not comply with the flowchart of the hepatitis B countermeasure guideline, and promotes correct HBV medical treatment in our hospital. We conducted a prospective study of HBV reactivation using this system. Methods Among 21,607 cases that were managed using this system, 1,206 patients who were HBs antigen-negative, HBc antibody- and/or HBs antibody-positive and in whom HBV DNA quantification was performed two times or more were examined for the occurrence of HBV reactivation. The study population included: malignant lymphoma patients using rituximab (n=40), patients with malignant tumors using anticancer agents (n=546), patients treated with steroids (n=274), rheumatoid arthritis (RA) patients (n=144), patients using immunosuppressants/biologics (n=26), and patients undergoing hepatitis C direct acting antiviral (DAA) treatment (n=176). Results HBV reactivation was observed in 27 cases undergoing treatment with the following agents: rituximab (n=6), anticancer agents (n=8), steroids (n=10), anti-RA agents (n=1), and hepatitis C DAA (n=2). Among the 40 patients who were using rituximab, 6 (18.2%) showed a high rate of reactivation. In 10 in which HBV reactivation occurred at a median of 10 (range, 4-32) months after steroid administration, 6 occurred after the 7th month, and 1 patient showed HBs antigen positivity and severe hepatitis. Conclusion Continuing of the operation of an automatic check system using coded medical information to check for the reactivation enabled this prospective study of HBV reactivation. Careful attention should be paid to patients using steroids, as well as malignant lymphoma patients who are treated with rituximab. The results of the present study suggest that the present IT encoding system would be useful for preventing HBV reactivation.
Databáze: OpenAIRE