Liver toxicity during immune checkpoint inhibitor treatment is mostly due to immune mediated hepatitis. Viral hepatitis, as well as auto-immune or metabolic hepatitis, are considered as exclusion criteria for ICI induced immune hepatitis diagnosis. However, considering the high prevalence of viral hepatitis B infection and the increasing prescription of immune checkpoint inhibitors, their use in patients with HBV chronic viral infection may be common, even more if patients are treated for hepatocellular carcinoma. Few clinical studies directly deal with the risk of HBV reactivation during ICI therapy and real-life data is currently based on five reported cases of HBV reactivation, one with fatal outcome. In this review, we summarize the current available clinical information about HBV reactivation risk during ICI treatment, its hypothetic mechanism, and propose practical recommendations about verifying and monitoring HBV status throughout the treatment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.dld.2020.08.041 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Metformin in Antiviral Therapy: Evidence and Perspectives.
Viruses
December 2024
Department of Microbiology, Virology, and Immunology, I. Horbachevsky Ternopil National Medical University, 46001 Ternopil, Ukraine.
Metformin, a widely used antidiabetic medication, has emerged as a promising broad-spectrum antiviral agent due to its ability to modulate cellular pathways essential for viral replication. By activating AMPK, metformin depletes cellular energy reserves that viruses rely on, effectively limiting the replication of pathogens such as influenza, HIV, SARS-CoV-2, HBV, and HCV. Its role in inhibiting the mTOR pathway, crucial for viral protein synthesis and reactivation, is particularly significant in managing infections caused by HIV, CMV, and EBV.
View Article and Find Full Text PDFSpontaneous reactivation of resolved HBV infection in the absence of immunosuppression: case report and literature review.
Diagn Microbiol Infect Dis
December 2024
Ministry of Health Sivas Numune Hospital, Specialist Doctor Department of Infectious Diseases and Clinical Microbiology, Yesilyurt neighbourhood, Sifa street No:4, 58060 Sivas, Türkiye. Electronic address:
It is estimated that two billion people worldwide are infected with hepatitis B. In such cases, patients exposed to the virus may experience HBV-reactivation(HBVr), which is usually due to immunosuppression. It is not anticipated that spontaneous-HBVr will occur in the absence of immunosuppression in resolved HBV.
View Article and Find Full Text PDFHepatitis B Virus Reactivation in Patients With HBV-Related Advanced Hepatocellular Carcinoma Undergoing Lenvatinib and Camrelizumab Treatment.
Cancer Control
January 2025
Department of Pharmacy, Wuhan Third Hospital, Wuhan, China.
Objective: This study aimed to evaluate hepatitis B virus (HBV) reactivation and its effect on tumor response and survival outcomes in patients with HBV-related advanced hepatocellular carcinoma (HCC) undergoing lenvatinib plus camrelizumab treatment.
Methods: 216 patients with HBV-related advanced HCC receiving lenvatinib and camrelizumab were enrolled. Overall survival (OS), progression-free survival, and tumor response were evaluated.
Similar Hepatitis B virus reactivation risk for patients with inflammatory arthritis or connective tissue diseases: a multicenter retrospective study.
Rheumatol Int
January 2025
Department of Pathophysiology, National and Kapodistrian University of Athens, Athens, Greece.
Introduction: Hepatitis B reactivation and administration of prophylactic antiviral treatment are considered in patients with autoimmune inflammatory rheumatic diseases (AIIRD) undergoing immunosuppressive/immunomodulatory treatment. Data are more robust for rheumatoid arthritis patients receiving bDMARDs but are limited for other AIIRD and drug categories.
Methods: Adult patients with AIIRD (inflammatory arthritis [IA] or connective tissue diseases [CTD]) and documented chronic or resolved HBV infection (defined as serum HBsAg positivity or anti-HBcAb positivity in the case of HBsAg non-detection respectively), followed-up in six rheumatology centers in Greece and Italy, were included.
A Sleeping Giant: Late HBV Reactivation After Rituximab-Based Chemotherapy Despite Correct Prophylaxis.
Int Med Case Rep J
December 2024
Clinical Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland.
Hepatitis B virus (HBV) reactivation is a recognized complication of long-term immunosuppressive or cytotoxic therapy, typically occurring during immunosuppression or within a few months after treatment. To mitigate this risk, hepatological societies recommend the use of nucleos(t)ide analogues (NA) for HBV reactivation prophylaxis, along with post-treatment monitoring; though, these recommendations are not universally consistent across different guidelines. We present a case of late HBV reactivation in a 76-year-old male with occult HBV infection who received rituximab-based therapy for chronic lymphocytic leukemia.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!