Temporal Patterns of HBV Reactivation in Rituximab-Treated CKD Patients: An Exploratory Analysis of Baseline Quantitative HBsAg and Prophylaxis Duration
Retrospective study shows extended antiviral prophylaxis reduces HBV reactivation in rituximab-treated CKD, indicating that 12 to 18 months of treatment offers optimal protection.
Key Points
To assess clinical predictors of hepatitis B virus (HBV) reactivation, determine optimal antiviral prophylaxis duration, and identify risk kinetics after discontinuing prophylaxis in HBsAg-positive chronic kidney disease patients receiving rituximab.
Retrospective analysis of N=105 HBsAg-positive chronic kidney disease patients treated with rituximab.
Participants were stratified by duration of antiviral prophylaxis: Group A (≥12-18 months, n=41), Group B (6-12 months, n=47), and Group C (<6 months, n=17).
Analyzed reactivation rates and risk predictors using univariate logistic regression, log-rank tests, and Kaplan-Meier curves.
Overall HBV reactivation occurred in 7.6% (8/105) of patients, with rates exhibiting a significant duration-dependent decrease across groups: 2.4% in Group A, 6.4% in Group B, and 23.5% in Group C (P = 0.012).
Significant clinical predictors for reactivation were baseline HBsAg > 2.4 log10 IU/mL (OR = 12.5, P = 0.005) and prophylaxis duration < 6 months (OR = 6.8, P = 0.023).
Kaplan-Meier survival curves revealed a distinct temporal clustering of HBV reactivation occurring between 4 and 10 months following prophylaxis discontinuation.