ArticleInternational journal of clinical oncology2026
Prevention of hepatitis B virus reactivation according to hepatitis B surface antigen status in patients receiving systemic chemotherapy in Japan using an electronic medical record database.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
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Abstract
backgroundHepatitis B virus (HBV) reactivation is a critical complication in patients receiving systemic chemotherapy. While current guidelines recommend screening, whether appropriate preventive measures are implemented based on screening results remains unclear. This study aimed to evaluate the implementation of HBV screening and subsequent preventive measures according to hepatitis B surface antigen (HBsAg) status in patients undergoing chemotherapy in Japan.
methodsThis retrospective cohort study utilized Japan's largest electronic medical record database to evaluate HBV management in adults (≥ 20 years) who initiated anticancer therapy between 2006 and 2020. Patients with prior HBV treatment were excluded. We assessed the implementation proportions of key steps in HBV management, including initial HBsAg screening, subsequent antibody and DNA testing based on results, and prophylactic antiviral therapy initiation.
resultsOf 162,040 eligible patients, 93,801 (57.9%) underwent HBV screening. Among HBsAg-negative patients, only 29.4% received subsequent hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti-HBs) testing. HBV DNA testing was performed in 56.0% of patients positive for anti-HBc or anti-HBs. Only 18.3% of HBsAg-positive patients eligible for prophylaxis received nucleoside analogs. Screening and prophylaxis proportions improved over time, with the proportion receiving prophylactic administration reaching 27.1% in 2020. Screening was most frequent in patients with hematologic malignancies (58.3%) and in those receiving anti-CD20 antibodies (65.6%).
conclusionDespite suboptimal initial HBV screening proportions in Japan, a substantial gap remains in implementing subsequent preventive measures, particularly prophylactic therapy for HBsAg-positive patients. This highlights the critical need to improve adherence to guidelines to prevent HBV reactivation.
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