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Optimizing antiviral agents for hepatitis B management in malignant lymphomas
Oluwatobi O Ozoya1, Julio Chavez2, Lubomir Sokol2
1Emergency and Trauma Center, Tampa General Hospital, Tampa, FL, USA.
Annals of Translational Medicine
|March 3, 2017
Summary
Optimizing antiviral therapy for lymphoma patients with hepatitis B virus (HBV) infection is crucial. Early antiviral treatment initiation and monitoring can prevent HBV reactivation and improve outcomes.
Area of Science:
- Hepatology
- Oncology
- Virology
Background:
- Hepatitis B virus (HBV) infection poses significant risks for lymphoma patients, including HBV reactivation and poor treatment outcomes.
- Undiagnosed chronic hepatitis complicates screening and management, as reliance solely on HBsAg can be insufficient.
- Optimizing antiviral therapy is essential for this vulnerable patient group.
Purpose of the Study:
- To review and synthesize current literature on optimizing antiviral therapy for lymphoma patients with HBV infection or at risk of HBV reactivation.
- To identify best practices for preventing and managing HBV reactivation during immunosuppressive therapy for lymphoma.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Embase, Ovid Medline, and Scopus.
- Keywords included "chronic hepatitis B", "occult hepatitis B", "malignant lymphoma", "antiviral", and "HBV reactivation".
- The search was limited to articles published between 2001 and 2016.
Main Results:
- Nucleos(t)ide analogues like entecavir, tenofovir, and lamivudine are recommended.
- Antiviral therapy should ideally commence concurrently with or before immunosuppressive treatment.
- Laboratory monitoring, including HBV genotyping and HBV DNA levels, aids in predicting treatment response.
Conclusions:
- Optimizing antiviral therapy requires a multifaceted approach considering HBV prevalence, cost, screening methods, and patient-specific factors.
- Close collaboration with hepatitis experts is vital for tailored management strategies.
- Individualized treatment plans considering immunosuppressive therapy type and duration are necessary for effective HBV management in lymphoma patients.
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