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Researchers find HBV screening rate low in patients undergoing chemo
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A majority of patients undergoing chemotherapy were not screened for hepatitis B virus infection, according to data published in Clinical Gastroenterology and Hepatology.
In a retrospective study, researchers analyzed electronic medical records from a pharmacy database of 8,005 patients who were undergoing cytotoxic chemotherapy to treat solid or hematologic malignancies at the Mayo Clinic between January 2006 and September 2011.
“Only a small percentage of patients receiving chemotherapy are screened for HBV infection. Strategies are needed to ensure that patients receiving chemotherapy are protected from the consequences of undiagnosed HBV infection,” the researchers wrote.
Of all the patients undergoing chemotherapy (median age; 61 years), “1,279 were screened for HBV infection before chemotherapy (16%), including 668 of 1,805 patients with hematologic malignancies (37%),” the researchers wrote.
The median time between HBV screening and chemotherapy was 6 months, according to the research. A number of patients were tested for HBV after chemotherapy began (n = 523), with a time gap of 0.47 years.
Logistic regression analysis showed the amount of patients screened for HBV increased from 14.3% between 2006 and 2008 to 17.7% between 2009 and 2011 (P < .01). The researchers attributed the increased screening rate to an increase in the proportion of patients with hematologic malignancies, which also increased between periods 2006 and 2008 and 2009 and 2011 (32.7% vs. 40.6%; P < .01).
Overall, 13 patients tested positive for HBV, of which only 1% had been tested, including two diagnosed after chemotherapy began. Five of the 13 patients did not receive prophylactic antiviral therapy and HBV infection was reactivated in two of these patients, the researchers said. Some patients who were not screened showed increased levels of alanine aminotransferase (n = 58; >300 U/L). However, only one patient appeared to have undiagnosed HBV.
“There remains a clear difference between guideline recommendations by the liver societies and those by the oncology community with regard to HBV screening before chemotherapy,” the researchers wrote. – by Melinda Stevens
Disclosures: The researchers report no relevant financial disclosures.
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