Incidence and risk factors of hepatitis B virus reactivation in patients with multiple myeloma in an era with novel agents: a nationwide retrospective study in Japan

This is the authors' abstract. We don't add key points for this paper.

An estimated two billion people worldwide have been infected with the hepatitis B virus (HBV). Specifically, the prevalence of HBV infection is particularly high in Asia, including Japan. HBV reactivation (HBVr) can occur in HBV carriers and in patients with resolved HBV infection who are receiving cancer chemotherapy. HBVr can induce severe flares of hepatitis and lead to fatal fulminant hepatitis. With the increasing availability of rituximab-based regimens, HBVr has become a well-known complication of lymphoma chemotherapy. However, before the era of novel agents, such as proteasome inhibitors and immunomodulatory drugs (IMiDs), there were few reports of HBVr in patients with multiple myeloma (MM). Since the approval of these novel agents, the number of reports has increased 1 , 2 , 3 . In our previous study of 641 patients with MM, we reported that 9 of 99 (9.1%) patients with resolved HBV infection experienced HBVr 4 . Furthermore, the cumulative incidences of HBVr at 2 and 5 years were 8% and 14%, respectively. While our previous study concluded that HBVr was not rare, reasonable risk factors were not identified 4 . Therefore, this nationwide retrospective study aimed to evaluate the actual incidence and risk factors of HBVr in Japanese patients with MM.