Antiviral Prophylaxis With Tenofovir for Patients With History of Hepatitis B Receiving Oncology Drug Treatment

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Project Status:
Completed
Project Line:
Health Technology Review
Project Sub Line:
Rapid Review
Project Number:
RC1448-000
Effective finish date:

Question

  1. What is the clinical effectiveness of antiviral prophylaxis with tenofovir for patients with history of hepatitis B who are receiving oncology drug treatment?
  2. What are the evidence-based guidelines for antiviral prophylaxis with tenofovir for patients with history of hepatitis B who are receiving oncology drug treatment?

Key Message

  • One randomized control trial and 2 retrospective cohort studies found no significant differences between tenofovir and entecavir in the prophylaxis of hepatitis B virus reactivation in patients who were hepatitis B surface antigen positive and/or hepatitis B core antibody positive receiving chemotherapy or immunosuppressive therapy. There were no significant differences between these 2 drugs regarding renal function and other side effects.
  • One randomized controlled trial found no patients in the tenofovir prophylaxis group had HBV reactivation compared to 10.7% in the observational group. However, the difference did not reach the level of statistical significance, probably owing to a small sample size. There were no significant differences between groups in terms of renal function, liver function, and other side effects.
  • All 8 included guidelines strongly recommend the use of tenofovir or entecavir as antiviral prophylaxis in all patients with high risk of hepatitis B virus reactivation (hepatitis B surface antigen positive and/or hepatitis B core antibody positive) during chemotherapy or immunosuppressive therapy.