Screening for Hepatitis B in Patients with Lymphoma

Chronic hepatitis B virus (HBV) infection can be reactivated during lymphoma chemotherapy, specifically with rituximab. In 2008, the Centers for Disease Control and Prevention and, in 2010, the American Society of Clinical Oncology made recommendations that anyone who received cytotoxic or immunosup...

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Bibliographic Details
Published in:	Proceedings - Baylor University. Medical Center Vol. 28; no. 4; pp. 438 - 442
Main Authors:	Ramirez, Jonathan, Duddempudi, Anupama Thadareddy, Sana, Moazzam M., Hasan, Syed S., Santos, Mario De Los, Song, Juhee, Fang-Hollingsworth, Ying, Gupta, Sandeep S., Sears, Dawn M.
Format:	Journal Article
Language:	English
Published:	United States Taylor & Francis 01-10-2015 Taylor & Francis Group LLC Taylor & Francis Ltd Baylor Health Care System
Subjects:	Diagnosis Health aspects Hepatitis B Lymphomas Original Research Risk factors United States
Online Access:	Get full text
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Summary:	Chronic hepatitis B virus (HBV) infection can be reactivated during lymphoma chemotherapy, specifically with rituximab. In 2008, the Centers for Disease Control and Prevention and, in 2010, the American Society of Clinical Oncology made recommendations that anyone who received cytotoxic or immunosuppressive therapy should be tested for serologic markers of HBV infection. In our study, we wanted to determine the screening rates for HBV infection at our institution and if simply adding a checkbox onto the rituximab order would improve HBV screening. We performed a retrospective chart review of two cohorts of lymphoma patients at Scott & White Health Clinic. Cohort 1 included patients from 1993 to 2008. Cohort 2 included patients who received rituximab after an institutionwide protocol (rituximab order checkbox) was initiated in 2011. A total of 452 patients treated for lymphoma were reviewed. Only 15 of the 404 Cohort 1 patients received HBV screening (3.7%; 95% confidence interval, 2.1%-6.1%). Screening rates were statistically higher if baseline liver laboratory values were elevated (P < 0.0001). HBV was also checked more frequently if patients' liver function tests became elevated while on chemotherapy, 85.7% (12/14). Of the 48 patients in Cohort 2, 33 patients (68.7%) received HBV screening. No patients in either cohort had a positive HBV surface antigen or developed reactivation of HBV during chemotherapy. The addition of a checkbox on the rituximab order form significantly increased our screening for HBV infection in lymphoma patients initiating chemotherapy.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0899-8280 1525-3252
DOI:	10.1080/08998280.2015.11929300