Management of Hepatitis B Virus Reactivation after the Completion of Cancer Chemotherapy using a Plan-do-Check-Act Cycle

Satoshi Hibi; Kenji Ina; Shu Yuasa; Nobuto Ito; Yuko Shirokawa; Kengo Nanya; Yuko Kato; Takashi Yoshida; Satoshi Kayukawa

doi:10.30683/1929-2279.2022.11.11

Authors

Satoshi Hibi Department of Hospital Pharmacy, Nagoya Memorial Hospital, Japan and Chemotherapy Team, Nagoya Memorial Hospital, Japan
Kenji Ina Department of Geriatric Medicine, Shinseikai Dai-ichi Hospital, Nagoya, Japan
Shu Yuasa Department of Hospital Pharmacy, Nagoya Memorial Hospital, Japan
Nobuto Ito Department of Hospital Pharmacy, Nagoya Memorial Hospital, Japan
Yuko Shirokawa Department of Nursing, Nagoya Memorial Hospital, Japan and Chemotherapy Team, Nagoya Memorial Hospital, Japan
Kengo Nanya Department of Clinical Laboratory, Nagoya Memorial Hospital, Japan
Yuko Kato Medical Social Work Consultation Room, Nagoya Memorial Hospital, Japan
Takashi Yoshida Department of Clinical Oncology, Nagoya Memorial Hospital, Japan and Chemotherapy Team, Nagoya Memorial Hospital, Japan
Satoshi Kayukawa Department of Clinical Oncology, Nagoya Memorial Hospital, Japan and Chemotherapy Team, Nagoya Memorial Hospital, Japan

DOI:

https://doi.org/10.30683/1929-2279.2022.11.11

Keywords:

Chemotherapy, Hepatitis B virus reactivation, HBV DNA, PDCA cycle, Multidisciplinary chemotherapy team

Abstract

The reactivation of the hepatitis B virus (HBV) following systemic chemotherapy reportedly caused acute liver dysfunction as a fatal complication. HBV reactivation sometimes occurs even after the cessation of chemotherapy, especially in the patients with hematological malignancies. A retrospective survey of patients with hepatitis B surface (HBs) antigen-negative cancer with HBs and/or HBc antibodies was conducted by a multidisciplinary chemotherapy team to determine the examination rate of the HBV DNA test after the completion of chemotherapy. Among 83 patients with a resolved HBV infection, who were followed up for more than 3 months, only 17 patients underwent HBV DNA monitoring every 1-3 months (17/83; 20.5%). Since September, 2022, the chemotherapy team has informed the attending physician regarding the continuous HBV DNA monitoring in patients with cancer with a resolved HBV infection until 12 months after the cessation of chemotherapy.

References

Kusumoto S, Tanaka Y, Suzuki R, et al. Monitoring of hepatitis B virus (HBV) DNA and risk of HBV reactivation in B-cell lymphoma: A prospective observational study. Clin Infect Dis 2015; 61: 719-29. https://doi.org/10.1093/cid/civ344 DOI: https://doi.org/10.1093/cid/civ344

Yamauchi N, Maruyama D, Choi I, et al. Prophylactic antiviral therapy for hepatitis B virus surface antigen-positive patients with diffuse large B-cell lymphoma treated with rituximab-containing chemotherapy. Cancer Sci 2021; 112: 1943-54. https://doi.org/10.1111/cas.14846 DOI: https://doi.org/10.1111/cas.14846

Kikuchi T, Kusumoto S, Tanaka Y, et al. Hepatitis B virus reactivation in a myeloma patient with resolved infection who received daratumumab-containing salvage chemotherapy. J Clin Exp Hematol 2020; 60: 51-4. https://doi.org/10.3960/jslrt.19034 DOI: https://doi.org/10.3960/jslrt.19034

Loomba R, Liang TJ. Hepatitis B reactivation associated with immune suppressive and biological modifier therapies: current concepts, management strategies, and future directions. Gastroenterology 2017; 152: 1297-309. https://doi.org/10.1053/j.gastro.2017.02.009 DOI: https://doi.org/10.1053/j.gastro.2017.02.009

Yeo W, Chan TC, Leung NWY, et al. Hepatitis B virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab. J Clin Oncol 2009; 27: 605-11. https://doi.org/10.1200/JCO.2008.18.0182 DOI: https://doi.org/10.1200/JCO.2008.18.0182

Drafting committee for hepatitis management guidelines, the Japan Society of Hepatology. Japan Society of Hepatology guidelines for the management of hepatitis B virus infection: 2019 update. Hepatol Res 2020; 50: 892-923. https://doi.org/10.1111/hepr.13504 DOI: https://doi.org/10.1111/hepr.13504

Hibi S, Ina K, Kabeya M, Inoue H, Shirokawa Y, Yuasa S. Quality and safety improvement in cancer chemotherapy using the Plan-Do-Check-Act cycle. Indian J Appl Res 2015; 12: 140-1.

Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013; 48: 452-8. https://doi.org/10.1038/bmt.2012.244 DOI: https://doi.org/10.1038/bmt.2012.244

Yeo W, Zee B, Zhong S, et al. Comprehensive analysis of risk factors associating with hepatitis B virus (HBV) reactivation in cancer patients undergoing cytotoxic chemotherapy. Br J Cancer 2004; 90: 1306-11.

https://doi.org/10.1038/sj.bjc.6601699 DOI: https://doi.org/10.1038/sj.bjc.6601699

Kim HY, Kim W. Chemotherapy-related reactivation of hepatitis B infection: updates in 2013. World J Gastroenterol. 2014; 20: 14581-8.

https://doi.org/10.3748/wjg.v20.i40.14581 DOI: https://doi.org/10.3748/wjg.v20.i40.14581

Evens AM, Jovanovic BD, Su Y-C, et al. Rituximab-associated hepatitis B virus (HBV) reactivation in lymphoproliferative diseases: meta-analysis and examination of FDA safety reports. Ann Oncol 2011; 22: 1170-80.

https://doi.org/10.1093/annonc/mdq583 DOI: https://doi.org/10.1093/annonc/mdq583