Hepatitis B in patients with hematological diseases: An update

Table 1 Virological categories of hepatitis B virus infected patients (adapted from[5])

	AC	IC	pOBI
HBsAg	+	+	-
Anti-HBc	+	+	+
Anti-HBs	-	-	-/+
qHBsAg	≥ 1000	< 1000	-
ALT	Increased	Normal	Normal
HBV DNA in the blood	≥ 2000	< 2000	-
Liver stiffness (kPa)	> or < 6	< 6	< 6

HBsAg: Hepatitis B surface antigen; AC: Active carrier; IC: Inactive carrier; OBI: Occult hepatitis B virus (HBV) infection; Anti-HBc: Anti-hepatitis B core antigen antibodies; Anti-HBs: Antibodies to HBV surface antigen.

Table 2 Incidence of hepatitis B virus reactivation without prophylaxis (adapted from[21])

Disease	HBsAg+ (%)	HBsAg-/anti-HBc+ (%)
Lymphoma	18-73	34-68
Acute leukaemias	61	2.8-12.5
Multiple myeloma	Not available	6.8-8
Breast cancer	21-41	Not available
Hepatocellular cancer (systemic chemotherapy)	36	11
Inflammatory bowel disease	36	0-7
Autoimmune diseases	Not available	17

HBsAg: Hepatitis B surface antigen; Anti-HBc: Anti-hepatitis B core antigen antibodies.

Table 3 Risk of hepatitis B virus reactivation according to different immunosuppressive drug classes (adapted from[21])

Risk	Drug class
High (> 10%)	B-cell depleting agents
	Anthracycline
	Corticosteroids high dose
Moderate (1%-10%)	TNFα inhibitors
	Cytokine and integrin inhibitors
	Tyrosine kinase inhibitors
	Corticosteroids moderate dose
Low (< 1%)	Corticosteroids low dose
	Traditional immunosuppression (e.g., azathioprine or methotrexate)