ArticlePloS one2015
Poor recognition of risk factors for hepatitis B by physicians prescribing immunosuppressive therapy: a call for universal rather than risk-based screening.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance.Hepatology (Baltimore, Md.) · 2018Guideline
- Low value of routine serological screening for hepatitis B in patients with rheumatoid arthritis starting rituximab therapy in a nonendemic region.EULAR rheumatology open · 2026Article
- A Qualitative Exploration of Family and Marital Challenges Faced by the Hepatitis-B Positive Patients and Their Partners in Central India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2025Article
- Self-reported hepatitis B testing among noninstitutionalized adults in the United States before the implementation of universal screening, 2013-2017: A nationwide population-based study.Journal of viral hepatitis · 2024Article
- Impact of universal hepatitis B virus (HBV) screening using chemotherapy orders on the HBV reactivation in cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Observational
- Latent Tuberculosis Screening Among New Users of a Biologic or Targeted Synthetic Disease-Modifying Antirheumatic Drug: Gaps in Screening Overall and Among Janus Kinase Inhibitors.Arthritis care & research · 2024Article
- Hepatitis B virus reactivation in rheumatoid arthritis.World journal of clinical cases · 2022Review
- Hepatitis B Screening Before Biologic or Targeted Synthetic Disease-modifying Antirheumatic Drug Therapy: Many Roads to Improvement.The Journal of rheumatology · 2022Article
- Screening for Hepatitis B Virus Prior to Initiating Tocilizumab and Tofacitinib in Patients With Rheumatic Diseases: A Cross-sectional Study.The Journal of rheumatology · 2022Article
- Prevention of hepatitis B reactivation in patients requiring chemotherapy and immunosuppressive therapy.World journal of clinical cases · 2021Review
- HBV Reactivation During the Treatment of Non-Hodgkin Lymphoma and Management Strategies.Frontiers in oncology · 2021Review
- RISE registry reveals potential gaps in medication safety for new users of biologics and targeted synthetic DMARDs.Seminars in arthritis and rheumatism · 2020Article
- Rheumatologists' awareness of hepatitis B reactivation before immunosuppressive therapy.Rheumatology international · 2019Article
- Gaps in Ambulatory Patient Safety for Immunosuppressive Specialty Medications.Joint Commission journal on quality and patient safety · 2019Article
- Hepatitis B Reactivation Associated With Immune Suppressive and Biological Modifier Therapies: Current Concepts, Management Strategies, and Future Directions.Gastroenterology · 2017Review
- Using health-system-wide data to understand hepatitis B virus prophylaxis and reactivation outcomes in patients receiving rituximab.Medicine · 2017Observational
- Screening rate for hepatitis B virus infection in patients undergoing chemotherapy in Japan.International journal of clinical oncology · 2016Article
- Gastroenterologists Have Suboptimal Hepatitis B Virus Screening Rates in Patients Receiving Immunosuppressive Therapy.Digestive diseases and sciences · 2016Article
- Hepatitis B Reactivation with Novel Agents in Non-Hodgkin's Lymphoma and Prevention Strategies.Journal of clinical and translational hepatology · 2016Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReactivation of hepatitis B virus (HBV) during immunosuppressive therapy (IST) can lead to severe and even fatal hepatitis but can be largely prevented with prophylactic antiviral therapy. Screening for HBV prior to starting IST is recommended. Both risk-based and universal screening have been recommended by different societies. For effective risk-based screening, physicians must be aware of risk factors for chronic HBV infection.
methodsThe HBV screening practices prior to starting IST of rheumatologists, medical and hematological oncologists were evaluated by survey and chart review. Country of origin, the primary risk factor for HBV exposure, was determined in all patients.
resultsOf 140 rheumatology, 79 medical oncology and 53 hematology patients reviewed, 81%, 11% and 81% were deemed to be at high risk of HBV reactivation by their physicians respectively, however only 27%, 6% and 62% (p<0.0001) were actually screened for HBV prior to starting IST. For patients from HBV-endemic regions, more hematology patients (53%) were correctly identified by their physicians as being at high risk of reactivation than rheumatology patients (2.4%, p=0.0001) or medical oncology patients (15%, p=0.009). However actual screening rates were not increased in patients from endemic regions. A total of 81 patients were screened for HBsAg; 2 were positive. Of the 33 patients screened for anti-HBc, 10 (30%) were positive.
conclusionsHematologists, rheumatologists and medical oncologists had low rates of screening for HBV prior to prescribing IST, largely due to poor identification of those at risk for infection. Risk-based screening strategies are unlikely to be effective and should be replaced by universal screening.
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