{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:15:04Z","timestamp":1789676104639,"version":"4.0.1"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Nacional do C\u00e2ncer Jos\u00e9 Alencar Gomes da Silva"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Rituximab promotes strong immunosuppression leading to a high risk of hepatitis B reactivation (HBV-R) and chronic infection. Current recommendations on HBV-R prevention are expensive and poorly individualized. In resolved hepatitis B patients, previous studies suggest that anti-HBs titers before immunosuppression can predict HBV-R risk. However, guidelines claim that additional data are necessary before recommending spare drug prophylaxis in patients with high anti-HBs titers. On the other hand, in patients with no previous contact with HBV, guidelines recommend vaccine before immunosuppression despite minimal evidence available. To shed light on these knowledge gaps, two prospective studies were conducted to evaluate anti-HBs in hematological cancer patients treated with rituximab. In the first study, anti-HBs-positive patients were referred for following up antibody titers before and during immunosuppression. Patients with anti-HBs \u2265 100 mIU\/mL before immunosuppression had no negative seroconversion (anti-HBs loss), in contrast to 18% of those with anti-HBs &lt; 100 mIU\/mL. In the second study, patients with no previous contact with HBV were invited to receive HBV vaccine before rituximab chemotherapy. None seroconverted with anti-HBs. In conclusion, both studies reinforce the need to review concepts about HBV prevention during immunosuppression on current guidelines. Narrowing the use of drug prophylaxis and improving vaccine indications are recommended.<\/jats:p>","DOI":"10.3390\/v14081780","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T03:40:32Z","timestamp":1660621232000},"page":"1780","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Hepatitis B Surface Antibody (Anti-HBs) Kinetics during Rituximab Chemotherapy and Performance of Hepatitis B Vaccine before Immunosuppression: Two Prospective Studies"],"prefix":"10.3390","volume":"14","author":[{"given":"Jo\u00e3o Marcello de","family":"Araujo-Neto","sequence":"first","affiliation":[{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Sousa","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Instituto Nacional do C\u00e2ncer Jose Alencar Gomes da Silva, Rio de Janeiro 20230-130, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia Ferreira","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Hospital Federal de Bonsucesso, Rio de Janeiro 21041-020, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9013-2570","authenticated-orcid":false,"given":"Marcelo A.","family":"Soares","sequence":"additional","affiliation":[{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil"},{"name":"Instituto Nacional do C\u00e2ncer Jose Alencar Gomes da Silva, Rio de Janeiro 20230-130, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1038\/nrgastro.2013.216","article-title":"Management of patients with hepatitis B who require immunosuppressive therapy","volume":"11","author":"Hwang","year":"2014","journal-title":"Nat. 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