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Mak JWY, Law AWH, Law KWT, Ho R, Cheung CKM, Law MF. Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies in the targeted therapy era. World J Gastroenterol 2023; 29(33): 4942-4961 [PMID: 37731995 DOI: 10.3748/wjg.v29.i33.4942]
World J Gastroenterol. Sep 7, 2023; 29(33): 4942-4961 Published online Sep 7, 2023. doi: 10.3748/wjg.v29.i33.4942
Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies in the targeted therapy era
Joyce Wing Yan Mak, Alvin Wing Hin Law, Kimmy Wan Tung Law, Rita Ho, Carmen Ka Man Cheung, Man Fai Law
Joyce Wing Yan Mak, Carmen Ka Man Cheung, Man Fai Law, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong 852, China
Alvin Wing Hin Law, Kimmy Wan Tung Law, West Island School, Hong Kong 852, China
Rita Ho, Department of Medicine, North District Hospital, Hong Kong 852, China
Author contributions: Mak JWY, Law AWH, Law KWT, Ho R, Cheung CKM, and Law MF were involved in the analysis of data/references; Mak JWY revised critically the manuscript; Law AWH, Law KWT, Cheung CKM, and Law MF contributed to the acquisition of data/references; Mak JWY, Cheung CKM, and Law MF contributed to the interpretation of data/references; Cheung CKM and Law MF drafted the manuscript; and all authors approved the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Man Fai Law, MRCP, Doctor, Department of Medicine and Therapeutics, Prince of Wales Hospital, 30-32 Ngai Shing Street, Shatin, Hong Kong 852, China. mflaw99@yahoo.com.hk
Received: May 29, 2023 Peer-review started: May 29, 2023 First decision: June 20, 2023 Revised: July 22, 2023 Accepted: August 15, 2023 Article in press: August 15, 2023 Published online: September 7, 2023 Processing time: 94 Days and 23.5 Hours
Core Tip
Core Tip: Patients with chronic or past resolved hepatitis B virus (HBV) infection are at risk of reactivation of the virus when they receive chemotherapy or immunosuppressive therapy. Therefore, before treatment, patients should be screened for HBV markers, specifically hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen. Prophylactic antiviral therapy is important for HBsAg-positive patients, and is a reasonable option for patients with resolved HBV infection who are scheduled to receive high-risk therapy such as anti-CD20 monoclonal antibodies, anti-CD79 monoclonal antibodies, bispecific antibodies, chimeric antigen receptor-T cell therapy, or hematopoietic stem cell transplantation. For other patients with resolved HBV infection, pre-emptive antiviral therapy guided by serial monitoring of HBV DNA is a reasonable option.
