Prophylactic Use of Entecavir for Lymphoma Patients With Past Hepatitis B Virus Infection: A Randomized Controlled Trial
| Autor: | Guiqiang Wang, Weiping Liu, Xiao Pei Wang, Mei Xue, Jun Zhu, Xiu Bin Xiao, Yu Qin Song |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Guanine Adolescent Lymphoma medicine.medical_treatment medicine.disease_cause Gastroenterology Antiviral Agents law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Internal medicine Medicine Humans Child Hepatitis B virus Hepatitis Chemotherapy business.industry virus diseases Infant Hematology Entecavir Hepatitis B Middle Aged medicine.disease digestive system diseases Oncology 030220 oncology & carcinogenesis Child Preschool 030211 gastroenterology & hepatology Female business medicine.drug |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 19(2) |
| ISSN: | 2152-2669 |
| Popis: | Background The value of prophylactic antiviral therapy in patients with past hepatitis B virus (HBV) infection (HBV surface antigen-negative/anti-HBV core antibody-positive/HBV DNA negative) is still controversial. Patients and Methods This study compared the safety, efficacy, and cost-effectiveness of prophylactic entecavir (ETV) with regular monitoring alone in lymphoma patients with past HBV infection. Patients were randomly assigned to chemotherapy alone (control) or prophylactic ETV before chemotherapy and at least 6 months after completion of chemotherapy. All patients underwent close virologic and biochemical surveillance. The primary end points were the incidence rates of HBV reactivation (appearance of HBV DNA) and HBV reactivation-related hepatitis (defined as a greater than 3-fold increase in serum alanine aminotransferase levels exceeding 100 IU/L). Results A total of 190 patients were included, 141 (74.2%) of whom were positive for anti-HBV surface antibody (HBs). The incidence rates of HBV reactivation and HBV reactivation-related hepatitis were 0 (0/95) and 0 (0/95) in the prophylactic ETV group, respectively, and 3.2% (3/95) and 1.1% (1/95) in the control group, respectively (P = .246 and 1.000, respectively). One patient experienced HBV reactivation-related hepatitis, resulting in premature termination of chemotherapy. All 3 patients with HBV reactivation recovered after therapeutic ETV treatment. No HBV-related deaths were observed during the follow-up period. The cost in the prophylactic ETV group was higher than that in the control group ($125 per month). Conclusion Prophylactic antiviral therapy is not a cost-effective strategy for the management of lymphoma patients with past HBV infection, especially those positive for anti-HBs. |
| Databáze: | OpenAIRE |
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