Vierling, Maria E. antibody to hepatitis B core antigen (anti-HBc) assessments as well as the prevalence and predictors of positive results. We explored rates of acutely elevated liver function assessments and liver decompensation after chemotherapy. Results: Of 10,729 new patients who received chemotherapy, 1,787 (16.7%) underwent HBsAg or anti-HBc screening. Less than 20% of patients with HBV risk factors were screened, even though their odds of HBV contamination were increased four-fold compared with those without risk factors. The prevalence of chronic HBV contamination was 1.5%. whereas 7.4% had positive anti-HBc only. The strongest predictors of HBV screening were having a history of HBV contamination, hematologic malignancy, and rituximab treatment ( .001). Asian ethnicity was not a significant predictor of screening, despite being a strong and highly significant predictor of positive test results ( .001). Conclusion: HBV screening among patients with cancer is usually HDAC10 low, especially among those known to be at high risk for HBV contamination. Future research directed toward identifying best screening methods and HBV risk tools will be necessary to reduce the risk of reactivation of HBV contamination after chemotherapy. Introduction Patients with chronic hepatitis B computer virus (HBV) contamination are at risk for reactivation after chemotherapy.1,2 Patients who have recovered from previous HBV contamination and patients with occult chronic HBV contamination are also at risk for reactivation.3 Reactivation may cause interruptions in chemotherapy and, in severe cases, lead to liver failure and death.4C6 Administration of oral anti-HBV medications before chemotherapy can reduce the risk of reactivation by more than 79% in patients with chronic HBV infection7; however, prophylaxis can only be initiated after HBV contamination ICI 118,551 hydrochloride has been recognized. In the United States, the prevalence of chronic HBV contamination as manifested by positive results on both hepatitis B ICI 118,551 hydrochloride surface antigen (HBsAg) and immunoglobulin G antibody to hepatitis B core antigen (anti-HBc) screening is less than 1% overall8 but may be as high as 3% to 9% among high-risk groups.8,9 The US prevalence of convalescent or occult chronic HBV infection as manifested by a negative HBsAg test result but a positive anti-HBc test result has been reported to be 5% to 8% overall10C12 and up to 15% to 46% in some high-risk groups.13,14 There is general agreement about the importance of HBV screening among patients with cancer; however, you will find differing opinions about the best screening approach. The Centers for Disease Control and Prevention (CDC) has recommended that all patients be screened for HBV contamination before administration of any immunosuppression,8 a recommendation endorsed by the Institute ICI 118,551 hydrochloride of Medicine.15 The National Comprehensive Malignancy Network has recommended that patients undergoing intensive immunosuppressive therapies ICI 118,551 hydrochloride be screened for prior HBV infection.16 The American Association for the Study of Liver Diseases has recommended that all persons at high risk for HBV be screened for prior HBV infection before chemotherapy.17 And the American Society of Clinical Oncology (ASCO) has recommended that only certain patientsthose at high risk for HBV infection or those who will be receiving highly immunosuppressive therapies such as stem-cell transplantation or rituximabbe screened for HBV infection before chemotherapy.18 Despite differences about which patients should be screened, all guidelines indicate that some ICI 118,551 hydrochloride form of systematic screening is needed to identify patients at risk for reactivation so that prophylaxis may be initiated. We hypothesized that patients with malignancy with risk factors for HBV contamination are not being systematically screened for HBV at the onset of chemotherapy. We tested our hypothesis by retrospectively studying determinants of HBV screening and test results in a cohort of patients with newly diagnosed malignancy who received chemotherapy at The University of Texas MD Anderson Malignancy Center (Houston, TX). Methods Patient Identification In this retrospective cohort study,.
