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Hepatitis B Virus Reactivation in Breast Cancer Patients Undergoing Chemotherapy: a review and meta-analysis of prophylaxis management.

Abstract

BACKGROUND & AIMS

Hepatitis B virus (HBV) reactivation during or after chemotherapy in breast cancer patients has become a remarkable clinical problem. Prophylactic nucleos(t)ide analogues (NAs) are recommended for breast cancer patients who are hepatitis B surface antigen (HBsAg) positive before chemotherapy. We performed an up-to-date meta-analysis to compare the efficacy of prophylactic lamivudine use with non-prophylaxis in HBsAg positive breast cancer patients undergoing chemotherapy.

METHODS

PubMed, the Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched for relevant articles until June 2016. Eligible articles comparing the efficacy of prophylactic lamivudine use with non-prophylaxis in HBsAg positive breast cancer patients undergoing chemotherapy were identified.

RESULTS

Eight studies which had enrolled 709 HBsAg positive breast cancer patients undergoing chemotherapy were analyzed. Lamivudine prophylaxis significantly reduced the rates of chemotherapy-associated hepatitis B flares in chronic hepatitis B in breast cancer compared with patients with non-prophylaxis (odds ratio [OR] = 0.15, 95% confidence interval [CI]: 0.07-0.35, P < 0.00001). Chemotherapy disruption rates attributed to HBV reactivation in the prophylaxis groups were significant lower than the non-prophylaxis groups (OR = 0.17, 95% CI: 0.07-0.43, P = 0.0002). Patients with lamivudine prophylaxis had a higher risk for tyrosine-methionine-aspartate-aspartate (YMDD) motif mutations than patients with non-prophylaxis (OR = 6.33, 95% CI: 1.01-39.60, P = 0.05).

CONCLUSIONS

Prophylactic antiviral therapy management is necessary for HBsAg positive breast cancer patients undergoing chemotherapy, in spite of high correlation with lamivudine-resistant HBV variants with YMDD motif-mutations. This article is protected by copyright. All rights reserved.

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  • Authors+Show Affiliations

    ,

    Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.

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    Department of oncology Surgery, The First Hospital of Lanzhou University, 1 Donggang West Road, Lanzhou, 730000, China.

    ,

    Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.

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    Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.

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    Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.

    Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China. Cardiff China Medical Research Collaborative, School of Medicine, Cardiff University, Cardiff, CF14 4XN, UK.

    Source

    Journal of viral hepatitis : 2017 Jan 10 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28072494