Affiliation:
1. Hepatobiliary Division, Department of Internal Medicine Kaohsiung Medical University Hospital Kaohsiung Taiwan
2. School of Medicine and Hepatitis Research Center College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University Kaohsiung Taiwan
3. Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital Kaohsiung Medical University Kaohsiung Taiwan
4. Department of Internal Medicine, Kaohsiung Municipal Ta‐Tung Hospital Kaohsiung Medical University Kaohsiung Taiwan
5. School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat‐sen University Kaohsiung Taiwan
Abstract
AbstractBackground and AimsWe aimed to explore the risk factors associated with virological and clinical relapse, as well as their impact on overall mortality, in hepatitis B virus (HBV)‐infected patients receiving nucleos(t)ide analogues (NUCs) therapy prior to chemotherapy initiation.MethodsFrom 2010 to 2020, we conducted a prospective cohort study involving patients with HBV infection undergoing cytotoxic chemotherapy. We utilized the Kaplan–Meier method and Cox proportional hazard regression models to assess risk factors.ResultsWe observed that TDF or TAF (HR: 2.16, 95% CI 1.06–4.41; p = .034), anthracycline (HR: 1.73, 95% CI 1.10–2.73; p = .018), baseline HBV DNA (HR: 1.55, 95% CI 1.33–1.81; p < .001) and end‐of‐treatment HBsAg titre >100 IU/mL (HR: 7.81, 95% CI 1.94–31.51; p = .004) were associated with increased risk of virological relapse. Additionally, TDF or TAF (HR: 4.91, 95% CI 1.45–16.64; p = .011), baseline HBV DNA (HR: 1.48, 95% CI 1.10–1.99; p = .009) and end‐of‐treatment HBsAg titre >100 IU/mL (HR: 6.09, 95% CI .95–38.87; p = .056) were associated with increased risk of clinical relapse. Furthermore, we found that virological relapse (HR: 3.32, 95% CI 1.33–8.32; p = .010) and clinical relapse (HR: 3.59, 95% CI 1.47–8.80; p = .005) significantly correlated with all‐cause mortality in HBV patients receiving cytotoxic chemotherapy with prophylactic NUCs therapy.ConclusionsThe risk of virological and clinical relapse was linked to baseline HBV DNA, end‐of‐treatment HBsAg levels and TDF or TAF for prophylaxis; additionally, experiencing relapse heightens the risk of all‐cause mortality. Further research is warranted to explore potential strategies for preventing virological and clinical relapse in high‐risk patients.