Skip to main content

Advertisement

SpringerLink
Log in

HBsAg-negative/anti-HBc-positive patients treated with rituximab: prophylaxis or monitoring to prevent hepatitis B reactivation?

  • Brief Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Rituximab (RTX) has been classified as a drug associated with a high risk for hepatitis B virus (HBV) reactivation in HbsAg-negative/anti-HBc-positive patients. However, data on frequency of HBV reactivation are limited especially for RTX monotherapy. Several new recommendations for screening, monitoring and prophylactic antiviral treatment have been published recently. Here, we report the real-life experience in the management and reactivation rate of HbsAg-negative/anti-HBc-positive patients treated with RTX with or without chemotherapy from a large cohort and discuss our results in the light of updated recommendations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Pattullo V. Prevention of Hepatitis B reactivation in the setting of immunosuppression. Clin Mol Hepatol. 2016;22:219–37.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Perrillo RP, Martin P, Lok AS. Preventing hepatitis B reactivation due to immunosuppressive drug treatments. JAMA. 2015;313:1617–8.

    Article  PubMed  Google Scholar 

  3. Hwang JP, Lok AS. Management of patients with hepatitis B who require immunosuppressive therapy. Nat Rev Gastroenterol Hepatol. 2014;11:209–19.

    Article  CAS  PubMed  Google Scholar 

  4. Reddy KR, Beavers KL, Hammond SP, Lim JK, Falck-Ytter YT. American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:215–9.

    Article  CAS  PubMed  Google Scholar 

  5. Perrillo RP, Gish R, Falck-Ytter YT. American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy. Gastroenterology. 2015;148:221–44.

    Article  PubMed  Google Scholar 

  6. Mitka M. FDA: Increased HBV reactivation risk with ofatumumab or rituximab. JAMA. 2013;310:1664.

    Article  CAS  PubMed  Google Scholar 

  7. EASL. Clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67:370–98.

    Article  Google Scholar 

  8. Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HL, Chen CJ, et al. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int. 2016;10:1–98.

    Article  CAS  Google Scholar 

  9. Terrault NA, Bzowej NH, Chang KM, Hwang JP, Jonas MM, Murad MH. AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63:261–83.

    Article  Google Scholar 

  10. Mikulska M, Lanini S, Gudiol C, Drgona L, Ippolito G, Fernandez-Ruiz M, et al. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) consensus document on the safety of targeted and biological therapies: an infectious diseases perspective (agents targeting lymphoid cells surface antigens [I]: CD19, CD20 and CD52). Clin Microbiol Infect. 2018;24(Suppl 2):71–82.

    Article  CAS  Google Scholar 

  11. Gonzalez SA, Perrillo RP. Hepatitis B virus reactivation in the setting of cancer chemotherapy and other immunosuppressive drug therapy. Clin Infect Dis. 2016;62(Suppl 4):306–13.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

C.L. is supported by the Federal Joint Committee (G-BA, German Federal Ministry of Health). J.R. is supported by the German Research Foundation (DFG). G.F. and J.J. Vehreschild have received research grants from the German Federal Ministry of Education and Research (BMBF).

Funding

None.

Author information

Authors and Affiliations

  1. Department I of Internal Medicine, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany

    Linda Drößler, Clara Lehmann, Karin Töpelt, Jörg J. Vehreschild, Jan Rybniker, Michael Hallek, Julia Fischer, Gerd Fätkenheuer & Norma Jung

  2. Department of Gastroenterology and Hepatology, University of Cologne, Cologne, Germany

    Dirk Nierhoff

  3. Institute of Pharmacy, University of Cologne, Cologne, Germany

    Verena Stormberg

  4. Institute of Virology, University of Cologne, Cologne, Germany

    Ulrike Wieland

  5. German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany

    Clara Lehmann, Jörg J. Vehreschild, Jan Rybniker & Gerd Fätkenheuer

  6. Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany

    Clara Lehmann & Jan Rybniker

Authors
  1. Linda Drößler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clara Lehmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karin Töpelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dirk Nierhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jörg J. Vehreschild
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jan Rybniker
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael Hallek
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Julia Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Verena Stormberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Gerd Fätkenheuer
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Ulrike Wieland
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Norma Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Norma Jung.

Ethics declarations

Conflict of interest

None to declare. LD, KT, GF, JF, VS, UW, JR, DN stated no conflicts of interest related to the article. JJV has served at the speakers bureau of Pfizer, Merck, Gilead, Basilea and Astellas, received research funding from Astellas, Gilead, Infectopharm, Merck/MSD, Basilea and Pfizer, has received travel assistance from Astellas, Gilead, Merck/MSD and Basilea, and is a consultant to Astellas, Gilead, Basilea and Merck/MSD. MH has received consultancy fee, speaker`s honoraria and research support from Roche/Gentech. CL has received travel grants from Gilead and BMS and speaking honorarium from Gilead, Janssen, ViiV and Abbvie. NJ has received lecture fees from Labor Stein, Novartis, Gilead, MSD, Infectopharm and travel grants from Gilead, Novartis and Basilea.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drößler, L., Lehmann, C., Töpelt, K. et al. HBsAg-negative/anti-HBc-positive patients treated with rituximab: prophylaxis or monitoring to prevent hepatitis B reactivation?. Infection 47, 293–300 (2019). https://doi.org/10.1007/s15010-019-01271-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-019-01271-z

Keywords

Search

Navigation