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Hepatitis B reactivation and immune check point inhibitors
Benoit Godbert 1 , Nadine Petitpain 2 , Anthony Lopez 3 , Yann-Eric Nisse 4 , Pierre Gillet 4
Affiliations
Affiliations
1
Department of Pneumology, Robert Schuman Hospital, Vantoux 57070, France.
2
Regional Pharmacovigilance Centre, Department of Clinical Pharmacology, Toxicology, University Hospital CHRU Nancy, Vandœuvre-lès-Nancy 54511, France. Electronic address: [email protected].
3
Department of Hepatogastroenterology, University Hospital CHRU Nancy, Vandœuvre-lès-Nancy 54511, France.
4
Regional Pharmacovigilance Centre, Department of Clinical Pharmacology, Toxicology, University Hospital CHRU Nancy, Vandœuvre-lès-Nancy 54511, France.
PMID: 32921602 DOI: 10.1016/j.dld.2020.08.041
Abstract
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.
Keywords: Case report; Fulminant hepatitis; Immune checkpoint inhibitors; Reactivation; Viral hepatitis.
Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. |
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