Many patients treated with rituximab not screened correctly for HBV infection

Adherence to the recommendations to screen for hepatitis B virus (HBV) before starting treatment with the high-risk immunosuppressive therapy rituximab and initiation of subsequent antiviral prophylaxis is poor, according to a study.

Of the 3176 patients included in this study, only 1448 (46%) were screened correctly, with 65% being screened correctly at academic hospitals compared with 32% at non-academic hospitals (P < 0.001).

Screening rates improved over time and across specialties, including from 32% prior to 2012 to 75% after 2020 among academic prescribers and 1% to 60%, respectively, among non-academic prescribers. Antiviral prophylaxis was initiated in 58% of patients with chronic HBV infection and 36% in patients with resolved HBV infection,

Overall, 7 patients had HBV reactivation, 1 resulting in fatal liver decompensation.

Reference
Brakenhoff SM, Hoekstra R, Honkoop P, et al. Patients treated with rituximab are poorly screened for hepatitis B infection: Data from a low-incidence country. Eur J Intern Med. 2022;S0953-6205(22)00415-0. doi: 10.1016/j.ejim.2022.11.024. Epub ahead of print. PMID: 36462966.