widespread vs. selective screening for hepatitis b infection prior to chemotherapy

Conditions: Cancer; Hepatitis B; HBV; Hepatitis B Infection; Malignant Neoplasm

Summary: this trial studies hepatitis b screening strategies of new cancer patients scheduled to undergo chemotherapy. patients with cancer and hepatitis b virus infection are at risk of reactivation of infection after chemotherapy. hepatitis b virus infection reactivation can be prevented by starting antivirals before chemotherapy in patients who are hepatitis b virus infection positive. hepatitis b screening may help doctors prevent the reactivation of hepatitis b virus infection after chemotherapy.

primary objectives: i. to derive a selective screening strategy that optimizes the identification of positive hepatitis b virus (hbv) infection cases in comparison to widespread screening of new cancer patients undergoing chemotherapy. secondary objectives: i. to determine the prevalence of risk factors among patients with unknown hbv infection status as well as among patients known to have hbv infection, determine the incidence of reactivation of hepatitis b virus (hbv) infection, rates of disruptions in cancer therapy, co-infection with hepatitis c virus (hcv) or human immunodeficiency virus (hiv), and mortality rates. outline: patients with unknown hbv infection status undergo 3 hbv screening tests (hepatitis b surface antigen \[hbsag\], hepatitis b core antibody \[anti-hbc\], and hepatitis b surface antibody \[anti-hbs\]) before chemotherapy. patients with known hbv infection status undergo either hbsag or anti-hbc screening tests if there is no evidence of hbv testing in the last 3 months. all patients complete hbv risk assessment survey. after completion of study, patients with hbv infection are followed up every 3 months for at least 12 months after completion of chemotherapy or end of study period.

Eligibility criteria:
inclusion criteria: * unknown hbv infection status/ known hbv infection status: md anderson patients with clinically confirmed cancer who present for their first chemotherapy appointment in the ambulatory treatment center (atc). * known hbv infection status: patients with evidence of hbv infection by either: * patients who have had a positive hbsag or anti-hbc test performed outside of md anderson within the last 3 months, and they have documented results in the electronic medical record at md anderson, and/or * patients currently taking a medication (e.g., lamivudine, entecavir, tenofovir, adefovir, telbivudine, interferon, or other federal drug administration \[fda\]-approved anti-hepatitis b drug) for the treatment of hbv infection. exclusion criteria: * unknown hbv infection status: patients who have had a positive hbsag or anti-hbc test performed outside of md anderson within the last 3 months, and they have documented results in the electronic medical record at md anderson. * unknown hbv infection status: patients currently taking a medication (e.g., lamivudine, entecavir, tenofovir, adefovir, telbivudine, interferon, or other fda-approved anti-hepatitis b drug) for the treatment of hbv infection.

Keywords: hepatitis b virus infection hbv cancer patients chemotherapy hbv screening strategy hbv care chronic hbv concomitant hbv infection viral infections