HBsAg-negative/anti-HBc-positive patients treated with rituximab: prophylaxis or monitoring to prevent hepatitis B reactivation?
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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.
KeywordsRituximab Hepatitis B Reactivation Risk groups Hematologic diseases Autoimmune diseases Monotherapy
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).
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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.
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