{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:50:39Z","timestamp":1761562239985,"version":"build-2065373602"},"reference-count":17,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T00:00:00Z","timestamp":1495065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA016672"],"award-info":[{"award-number":["CA016672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K07 CA132955"],"award-info":[{"award-number":["K07 CA132955"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["U01 DK082863"],"award-info":[{"award-number":["U01 DK082863"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Data on the incidence of adverse liver outcomes are limited for cancer patients with chronic (hepatitis B surface antigen [HBsAg]\u2013positive\/hepatitis B core antibody [anti\u2010HBc]\u2013positive) or past (HBsAg\u2010negative\/anti\u2010HBc\u2013positive) hepatitis B virus (HBV) after chemotherapy. This study was aimed at determining the impact of test timing and anti\u2010HBV therapy on adverse liver outcomes in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with solid or hematologic malignancies who received chemotherapy between 2004 and 2011 were retrospectively studied. HBV testing and anti\u2010HBV therapy were defined as early at the initiation of cancer therapy and as late after initiation. Outcomes included hepatitis flares, hepatic impairment, liver failure, and death. Time\u2010to\u2010event analysis was used to determine incidence, and multivariate hazard models were used to determine predictors of outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>There were 18,688 study patients (80.4% with solid tumors). The prevalence of chronic HBV was 1.1% (52 of 4905), and the prevalence of past HBV was 7.1% (350 of 4905). Among patients with solid tumors, late identification of chronic HBV was associated with a higher risk of hepatitis flare (hazard ratio [HR], 4.02; 95% confidence interval [CI], 1.26\u201012.86), hepatic impairment (HR, 8.48; 95% CI, 1.86\u201038.66), liver failure (HR, 9.38; 95% CI, 1.50\u201058.86), and death (HR, 3.90; 95% CI, 1.19\u201012.83) in comparison with early identification. Among patients with hematologic malignancies and chronic HBV, the risk of death was 7.8 (95% CI, 1.73\u201035.27) times higher for persons with late initiation of anti\u2010HBV therapy versus early initiation. Patients with late identification of chronic HBV had late or no anti\u2010HBV therapy. Chronic HBV predicted liver failure in patients with solid or hematologic malignancies, whereas male sex and late identification were predictors for patients with solid tumors.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Early identification correlates with early anti\u2010HBV therapy and reduces the risk of liver failure and death in chronic HBV patients receiving chemotherapy. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:3367\u201076<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30729","type":"journal-article","created":{"date-parts":[[2017,5,18]],"date-time":"2017-05-18T11:07:52Z","timestamp":1495105672000},"page":"3367-3376","source":"Crossref","is-referenced-by-count":15,"title":["Impact of the timing of hepatitis B virus identification and anti\u2013hepatitis B virus therapy initiation on the risk of adverse liver outcomes for patients receiving cancer therapy"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5896-4182","authenticated-orcid":false,"given":"Jessica P.","family":"Hwang","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Suarez\u2010Almazor","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott B.","family":"Cantor","sequence":"additional","affiliation":[{"name":"Department of Health Services Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Barbo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1779-7007","authenticated-orcid":false,"given":"Heather Y.","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sairah","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Chavez\u2010MacGregor","sequence":"additional","affiliation":[{"name":"Department of Health Services Research The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Donato\u2010Santana","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Eng","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Ferrajoli","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Fisch","sequence":"additional","affiliation":[{"name":"Medical Oncology Aim Specialty Health Deerfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Physicians Network, MD Anderson Cancer Center The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George R.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Rondon","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J.","family":"Shpall","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna S.","family":"Lok","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Michigan Ann Arbor Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,18]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization.Guidelines for the prevention care and treatment of persons with chronic hepatitis B infection.http:\/\/apps.who.int\/iris\/handle\/10665\/154590. 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