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- Title
Screening for viral hepatitis B infection in cancer patients before receiving chemotherapy – A systematic review and meta‐analysis.
- Authors
Maung, Soe Thiha; Deepan, Natee; Decharatanachart, Pakanat; Chaiteerakij, Roongruedee
- Abstract
Aim: We conducted a systematic review and meta‐analysis to assess the hepatitis B virus (HBV) screening rate in cancer patients before systemic chemotherapy, aiming to identify those needing antiviral prophylaxis for HBV reactivation. Methods: We searched PubMed, Embase, Scopus, and Google Scholar for relevant studies. The pooled screening rate was estimated using a random effects model. Subgroup analyses were conducted based on malignancy types, chemotherapy regimens, study period, and HBV endemic regions. Results: The meta‐analysis included 29 studies from various endemic regions (19 low‐endemic, three lower intermediate‐endemic, and seven higher intermediate‐endemic). These studies encompassed hematologic malignancies (n = 10), solid‐organ tumors (n = 4), and combinations (n = 15). Seven studies used rituximab‐containing regimens, four did not, and the remaining 11 did not specify chemotherapy regimens. The pooled screening rate was 57% (95% confidence interval [95%CI]: 46%–68%, I2 = 100%). Over time, screening rates improved from 37% (95%CI: 23%–53%) in 2006–2010 to 68% (54%–80%) in 2011–2015 and 69% (48%–84%) in 2016–2020. Screening rates were highest at 89% (74%–96%) in high endemic countries, followed by 60% (45–73%) in lower‐intermediate and 49% (34–64%) in low‐endemic countries. Patients with hematological malignancies had a higher screening rate than those with solid organ tumors, 65% (55%–74%) versus 37% (21%–57%), respectively. A screening rate was higher in patients receiving rituximab‐containing chemotherapy than non‐rituximab regimens, 68% (55%–79%) versus 45% (27%–65%). Conclusion: Despite existing guidelines, pre‐chemotherapy HBV screening rate remains unsatisfactory, with substantial heterogeneous rates globally. These findings underscore the need for effective strategies to align practices with clinical guidelines.
- Subjects
MEDICAL screening; VIRAL hepatitis; HEPATITIS B; RANDOM effects model; CANCER patients
- Publication
Asia Pacific Journal of Clinical Oncology, 2024, Vol 20, Issue 3, p335
- ISSN
1743-7555
- Publication type
Article
- DOI
10.1111/ajco.14055