Top

Published in:

01-12-2018 | Original Article

Antiviral prophylaxis for preventing reactivation of hepatitis B virus in rheumatic patients: a systematic review and meta-analysis

Authors: Jiang Su, Li Long, Kun Zou

Published in: Clinical Rheumatology | Issue 12/2018

Abstract

To estimate the risk of reactivation of hepatitis B virus (HBV) and evaluate the effectiveness of antiviral prophylaxis (AVP) in patients with different status of HBV infection undergoing antirheumatic therapies. We searched Cochrane Library, Medline, and EMBASE for randomized controlled trials (RCTs), quasi-RCTs, non-RCTs, cohort studies, or case series studies examining reactivation of HBV in patients undergoing antirheumatic therapy with or without AVP. We estimated the HBV reactivation rate (HRR) and its 95% confidence interval (CI) among different patient groups (indirect comparison). We also calculated rate ratio (RR), rate difference (RD) with their 95% CIs, and the number needed to treat (NNT) of AVP (direct comparison). Fifty-three case series studies with 2162 patients were included. The RD of AVP was − 0.13 (95% CI − 0.21 to − 0.05) for all patients, − 0.16 (95% CI − 0.26 to − 0.06) for rheumatic patients with chronic HBV infection, but not statistically significant for patients with other status of HBV infection. Lamivudine (RD − 0.10, 95% CI − 0.25 to 0.05) was less effective than other prophylactic antiviral drugs (RD − 0.31, 95% CI − 0.52 to − 0.11). The HHR varied from 55 to 5% by HBV status and treatment. There is limited evidence that AVP was effective for preventing reactivation of HBV in patients undergoing antirheumatic therapy. The effectiveness varies by patient HBV status and antiviral regimens. Rheumatic HBV carriers may be more beneficial from AVP, and lamivudine may be inferior to other AVP regimens. Findings in this study warrant further investigation in rigorous RCTs.

Available only for authorised users

Ott JJ, Stevens GA, Groeger J, Wiersma ST (2012) Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine 30(12):2212–2219. https://doi.org/10.1016/j.vaccine.2011.12.116 CrossRefPubMed

Lavanchy D (2004) Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 11(2):97–107CrossRef

MacLachlan JH, Cowie BC (2015) Hepatitis B virus epidemiology. Cold Spring Harbor Perspect Med 5(5):a021410. https://doi.org/10.1101/cshperspect.a021410 CrossRef

Liang X, Bi S, Yang W, Wang L, Cui G, Cui F, Zhang Y, Liu J, Gong X, Chen Y, Wang F, Zheng H, Wang F, Guo J, Jia Z, Ma J, Wang H, Luo H, Li L, Jin S, Hadler SC, Wang Y (2009) Epidemiological serosurvey of hepatitis B in China—declining HBV prevalence due to hepatitis B vaccination. Vaccine 27(47):6550–6557. https://doi.org/10.1016/j.vaccine.2009.08.048 CrossRefPubMed

Zou CJ, Zhu LJ, Li YH, Mo YQ, Zheng DH, Ma JD, Ou-Yang X, Pessler F, Dai L (2013) The association between hepatitis B virus infection and disease activity, synovitis, or joint destruction in rheumatoid arthritis. Clin Rheumatol 32(6):787–795. https://doi.org/10.1007/s10067-013-2170-1 CrossRefPubMed

Yeo W, Johnson PJ (2006) Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology 43(2):209–220. https://doi.org/10.1002/hep.21051 CrossRefPubMed

Loomba R, Rowley A, Wesley R, Liang TJ, Hoofnagle JH, Pucino F, Csako G (2008) Systematic review: the effect of preventive lamivudine on hepatitis B reactivation during chemotherapy. Ann Intern Med 148(7):519–528CrossRef

Rossi G, Pelizzari A, Motta M, Puoti M (2001) Primary prophylaxis with lamivudine of hepatitis B virus reactivation in chronic HbsAg carriers with lymphoid malignancies treated with chemotherapy. Br J Haematol 115(1):58–62CrossRef

Hsu C, Hsiung CA, Su IJ, Hwang WS, Wang MC, Lin SF, Lin TH, Hsiao HH, Young JH, Chang MC, Liao YM, Li CC, Wu HB, Tien HF, Chao TY, Liu TW, Cheng AL, Chen PJ (2008) A revisit of prophylactic lamivudine for chemotherapy-associated hepatitis B reactivation in non-Hodgkin’s lymphoma: a randomized trial. Hepatology 47(3):844–853. https://doi.org/10.1002/hep.22106 CrossRefPubMed

10.

Lok AS, McMahon BJ (2009) Chronic hepatitis B: update 2009. Hepatology 50(3):661–662. https://doi.org/10.1002/hep.23190 CrossRefPubMed

11.

Singh JA, Saag KG, Bridges SL Jr, Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR, Furst DE, Parks D, Kavanaugh A, O'Dell J, King C, Leong A, Matteson EL, Schousboe JT, Drevlow B, Ginsberg S, Grober J, St Clair EW, Tindall E, Miller AS, McAlindon T (2016) 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 68(1):1–26. https://doi.org/10.1002/art.39480 CrossRefPubMed

12.

Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT, American Gastroenterological Association I (2015) American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology 148(1):215–219; quiz e216–217. https://doi.org/10.1053/j.gastro.2014.10.039 CrossRefPubMed

13.

Mori S, Fujiyama S (2015) Hepatitis B virus reactivation associated with antirheumatic therapy: risk and prophylaxis recommendations. World J Gastroenterol 21(36):10274–10289. https://doi.org/10.3748/wjg.v21.i36.10274 CrossRefPubMedPubMedCentral

14.

Pattullo V (2016) Prevention of hepatitis B reactivation in the setting of immunosuppression. Clin Mol Hepatol 22(2):219–237. https://doi.org/10.3350/cmh.2016.0024 CrossRefPubMedPubMedCentral

15.

Vigano M, Serra G, Casella G, Grossi G, Lampertico P (2016) Reactivation of hepatitis B virus during targeted therapies for cancer and immune-mediated disorders. Expert Opin Biol Ther 16(7):917–926. https://doi.org/10.1080/14712598.2016.1177017 CrossRefPubMed

16.

Loomba R, Liang TJ (2017) Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology 152(6):1297–1309. https://doi.org/10.1053/j.gastro.2017.02.009 CrossRefPubMedPubMedCentral

17.

Mo YQ, Liang AQ, Ma JD, Chen LF, Zheng DH, Schumacher HR, Dai L (2014) Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state: a real-world clinical practice. BMC Musculoskelet Disord 15:449. https://doi.org/10.1186/1471-2474-15-449 CrossRefPubMedPubMedCentral

18.

Malespin M, Wong S, Siqueira F, Luc B, Ravaee B, Vainder C, Cotler SJ (2012) Barriers to treatment of hepatitis B in an urban Chinatown community. J Clin Gastroenterol 46(8):e66–e70. https://doi.org/10.1097/MCG.0b013e31824e159c CrossRefPubMed

19.

National Health Institute. Quality assessment tool for case series studies. https://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/tools/case_series. Accessed 20th May 2017

20.

Liu Z, Jiang L, Liang G, Song E, Jiang W, Zheng Y, Gong C (2017) Hepatitis B virus reactivation in breast cancer patients undergoing chemotherapy: a review and meta-analysis of prophylaxis management. J Viral Hepat 24(7):561–572. https://doi.org/10.1111/jvh.12672 CrossRefPubMed

21.

Wu YT, Li X, Liu ZL, Xu Z, Dai W, Zhang K, Wu JS, Arshad B, Wu KN, Kong LQ (2017) Hepatitis B virus reactivation and antiviral prophylaxis during lung cancer chemotherapy: a systematic review and meta-analysis. PLoS One 12(6):e0179680. https://doi.org/10.1371/journal.pone.0179680 CrossRefPubMedPubMedCentral

22.

Zhang MY, Zhu GQ, Zheng JN, Cheng Z, Van Poucke S, Shi KQ, Huang HH, Chen FY, Zheng MH (2017) Nucleos(t)ide analogues for preventing HBV reactivation in immunosuppressed patients with hematological malignancies: a network meta-analysis. Expert Rev Anti-Infect Ther 15(5):503–513. https://doi.org/10.1080/14787210.2017.1309291 CrossRefPubMed

23.

Paul S, Saxena A, Terrin N, Viveiros K, Balk EM, Wong JB (2016) Hepatitis B virus reactivation and prophylaxis during solid tumor chemotherapy: a systematic review and meta-analysis. Ann Intern Med 164(1):30–40. https://doi.org/10.7326/M15-1121 CrossRefPubMed

24.

Tang W, Chen L, Zheng R, Pan L, Gao J, Ye X, Zhang X, Zheng W (2015) Prophylactic effect of lamivudine for chemotherapy-induced hepatitis B reactivation in breast cancer: a meta-analysis. PLoS One 10(6):e0128673. https://doi.org/10.1371/journal.pone.0128673 CrossRefPubMedPubMedCentral

25.

Liu JY, Sheng YJ, Ding XC, Tang H, Tong SW, Zhang DZ, Zhou Z, Hu P, Liao Y, Ren H, Hu HD (2015) The efficacy of lamivudine prophylaxis against hepatitis B reactivation in breast cancer patients undergoing chemotherapy: a meta-analysis. J Formosan Med Assoc Taiwan yi zhi 114(2):164–173. https://doi.org/10.1016/j.jfma.2012.10.007 CrossRefPubMed

26.

Li H, Zhang HM, Chen LF, Chen YQ, Chen L, Ren H, Hu HD (2015) Prophylactic lamivudine to improve the outcome of HBsAg-positive lymphoma patients during chemotherapy: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 39(1):80–92. https://doi.org/10.1016/j.clinre.2014.07.010 CrossRefPubMed

27.

Paul S, Dickstein A, Saxena A, Terrin N, Viveiros K, Balk EM, Wong JB (2017) Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: a meta-analysis. Hepatology 66(2):379–388. https://doi.org/10.1002/hep.29082 CrossRefPubMed

28.

Yu S, Luo H, Pan M, Luis AP, Xiong Z, Shuai P, Zhang Z (2016) Comparison of entecavir and lamivudine in preventing HBV reactivation in lymphoma patients undergoing chemotherapy: a meta-analysis. Int J Clin Pharm 38(5):1035–1043. https://doi.org/10.1007/s11096-016-0358-6 CrossRefPubMed

29.

Yang C, Qin B, Yuan Z, Chen L, Zhou HY (2016) Meta-analysis of prophylactic entecavir or lamivudine against hepatitis B virus reactivation. Ann Hepatol 15(4):501–511PubMed

30.

Calica Utku A, Karabay O (2016) Treatment of chronic hepatitis B patients with tyrosine-methionine-aspartate-aspartate mutations. World J Gastroenterol 22(4):1727–1728. https://doi.org/10.3748/wjg.v22.i4.1727 CrossRefPubMedPubMedCentral

31.

Cheng AL, Hsiung CA, Su IJ, Chen PJ, Chang MC, Tsao CJ, Kao WY, Uen WC, Hsu CH, Tien HF, Chao TY, Chen LT, Whang-Peng J, Lymphoma Committee of Taiwan Cooperative Oncology G (2003) Steroid-free chemotherapy decreases risk of hepatitis B virus (HBV) reactivation in HBV-carriers with lymphoma. Hepatology 37(6):1320–1328. https://doi.org/10.1053/jhep.2003.50220 CrossRefPubMed

32.

Cantini F, Boccia S, Goletti D, Iannone F, Leoncini E, Panic N, Prignano F, Gaeta GB (2014) HBV reactivation in patients treated with antitumor necrosis factor-alpha (TNF-α) agents for rheumatic and dermatologic conditions: a systematic review and meta-analysis. Int J Rheumatol 2014:1–9CrossRef

33.

Scullard GH, Smith CI, Merigan TC, Robinson WS, Gregory PB (1981) Effects of immunosuppressive therapy on viral markers in chronic active hepatitis B. Gastroenterology 81(6):987–991PubMed

34.

Hoofnagle JH, Davis GL, Pappas SC, Hanson RG, Peters M, Avigan MI, Waggoner JG, Jones EA, Seeff LB (1986) A short course of prednisolone in chronic type B hepatitis. Report of a randomized, double-blind, placebo-controlled trial. Ann Intern Med 104(1):12–17CrossRef

35.

Sheen IS, Liaw YF, Lin SM, Chu CM (1996) Severe clinical rebound upon withdrawal of corticosteroid before interferon therapy: incidence and risk factors. J Gastroenterol Hepatol 11(2):143–147CrossRef

Title: Antiviral prophylaxis for preventing reactivation of hepatitis B virus in rheumatic patients: a systematic review and meta-analysis
Authors: Jiang Su
Li Long
Kun Zou
Publication date: 01-12-2018
Publisher: Springer London
Published in: Clinical Rheumatology / Issue 12/2018
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-018-4096-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 12/2018

Telomere dysfunction-related serological markers and oxidative stress markers in rheumatoid arthritis patients: correlation with diseases activity

Foot function in rheumatoid arthritis patients: a cross-sectional study

Evaluation of plasma microRNA expressions in patients with juvenile idiopathic arthritis

Anakinra treatment in macrophage activation syndrome: a single center experience and systemic review of literature

Anti-annexin A5 antibodies and 25-hydroxy-cholecalciferol in female patients with primary antiphospholipid syndrome

Support available for and perceived priorities of people with polymyalgia rheumatica and giant cell arteritis: results of the PMRGCAuk members’ survey 2017

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials