Antiviral prophylaxis for hepatitis B virus reactivation in T‐cell lymphoma patients with resolved hepatitis B virus infection

Hepatitis B virus (HBV) reactivation can lead to liver dysfunction, potentially disrupting antitumor treatment in patients with malignancies. The role of anti‐HBV prophylaxis in preventing HBV reactivation in T‐cell lymphoma (TCL) patients with resolved HBV infection remains unclear. We retrospectively included TCL patients with resolved HBV infection (hepatitis B surface antigen negative and HBV core antibody positive) who received anti‐lymphoma treatment at Sun Yat‐sen University Cancer Center between March 2004 and February 2024. Patients were categorized into the prophylaxis and non‐prophylaxis groups based on whether they received prophylactic anti‐HBV treatment. Propensity score matching (PSM) with a 1:1 ratio was conducted to balance the differences in baseline characteristics between the two groups. The primary endpoint was the HBV reactivation rate. A total of 174 eligible patients were included in the PSM cohort. After matching, no significant differences were observed in baseline characteristics between the prophylaxis group ( n = 87) and non‐prophylaxis group (n = 87). With a median follow‐up of 24.0 months (IQR, 11.0–38.5), the HBV reactivation rate was 0% (0/87) and 5.7% (5/87) ( p = .059) in the prophylaxis group and non‐prophylaxis group, respectively. Patients in the non‐prophylaxis group showed a higher cumulative HBV reactivation rate than those in the prophylaxis group ( p = .025). All the five patients who experienced HBV reactivation had encountered delays or discontinuation in their anti‐lymphoma therapy. These findings show that TCL patients with resolved HBV infection who received anti‐HBV prophylaxis had a lower rate of HBV reactivation, indicating the potential benefit of anti‐HBV prophylaxis treatment in this group of patients.