Hepatitis B virus (HBV) infection is a worldwide distributing viral disease. Hepatitis due to HBV reactivation may progress to chronic illness and associated with increased risk of hepatic failure and hepatocellular cancer. Rituximab (RTX) is an immunosuppressive agent, is particularly used in the treatment of non-Hodgkin’s Lymphoma. Patients have significant risk for HBV reactivation following chemotherapy with a RTX containing regimen. This study aimed to determine the HBV screening manner and reactivation rates in patients with hematological neoplasm following chemotherapy including Rituximab.
This is a single-centered retrospective cohort study. The serostatus of the 331 adults with hematological disorders who received chemotherapy regimen including RTX between years of 2006 and 2016 were enrolled. Patients who experienced reactivation were evaluated.
Only 130 of 331 patients were screened appropriately for HBV infection for 10 years period. We found 18 patients were Hepatitis B surface antigen (HBsAg) (+) and 16 (88.8%) of them received antiviral prophylaxis. Among screened patients 27 were HBsAg (-)/ AntiHBc (+) and only 10 (37%) of them received HBV prophylaxis. In total, 9 patients experienced reactivation, 6 were from screened and 3 were from unscreened group.
Incomplete screening and inappropriate prophylaxis may result in HBV reactivation in patients under RTX based chemotherapy and related complications such as death.

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