Evidence map›Paper›PMID 28128861›Full record

SynthesisHepatology (Baltimore, Md.)2017

Role of surface antibody in hepatitis B reactivation in patients with resolved infection and hematologic malignancy: A meta-analysis.

Sonali Paul, Aaron Dickstein, Akriti Saxena, Norma Terrin, Kathleen Viveiros, Ethan M Balk, John B Wong

Registry-linked trialAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Hepatology (Baltimore, Md.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04199715 (Immunologic Efficacy of Heplisav B Vaccine in Patients Undergoing Treatment With Immunosuppressive Medications), which is not on this map. Cited by 86 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 10 pooled it
13.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04199715 phase1completednot on this mapstarted 2019, after this paper: background citation

Immunologic Efficacy of Heplisav B Vaccine in Patients Undergoing Treatment With Immunosuppressive Medications

TypeinterventionalSponsorBaylor Research InstituteRan2019 to 2022Enrolled10ConditionsHepatitis BArmsHeplisav-B
3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 10 syntheses or guidelines pooled it, 154 citations in OpenAlex.

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  5. Hepatitis B Virus Screening and Management for Patients With Cancer Prior to Therapy: ASCO Provisional Clinical Opinion Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Guideline
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Sonali PaulSection of Gastroenterology, Center for Liver Diseases, The University of Chicago Medicine, Chicago, IL.
Aaron DicksteinDivision of Gastroenterology and Hepatology, Tufts Medical Center, Boston, MA.
Akriti SaxenaDivision of Gastroenterology, Boston Medical Center, Boston, MA.
Norma TerrinInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, and Biostatistics, Epidemiology and Research Design (BERD) Center, Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA.
Kathleen ViveirosDivision of Gastroenterology and Hepatology, Tufts Medical Center, Boston, MA.
Ethan M BalkBrown Center for Evidence-Based Medicine, Brown University School of Public Health, Providence, RI.
John B WongDivision of Clinical Decision Making, Tufts Medical Center, Boston, MA.
Tufts Medical Center · USBoston Medical Center · USBrown University · USTufts University · USUniversity of Chicago · US

Funding

Tufts Clinical and Translational Research InstituteUL1TR001064 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$26.4M
Tufts Clinical and Translation Science Institute (UL1)UL1TR000073 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2012 to 2013
$5.5M
NCATS NIH HHS UL1 TR000073NCATS NIH HHS UL1 TR001064
6 · The paper itself

Abstract

Patients with resolved hepatitis B virus (HBV) infection who are treated for hematological malignancies remain at risk for HBV reactivation. Because of conflicting studies about whether the antibody to hepatitis B surface antigen (anti-HBs) protects against reactivation in patients with resolved infection (hepatitis B surface antigen negative) receiving chemotherapy for hematological malignancies, we conducted a meta-analysis to determine if anti-HBs reduces HBV reactivation risk. We sought English-language studies through March 1, 2016, in Medline and other sources that examined reactivation in patients with resolved HBV infection receiving chemotherapy for hematologic malignancies. The absolute risks and odds ratio (OR) of reactivation with versus without anti-HBs were estimated in random-effects model meta-analyses. In 20 studies involving 1,672 patients not receiving antiviral prophylaxis, the reactivation risk was 14% (95% confidence interval [CI] 9.4%-19%) in 388 patients who had antibodies to hepatitis B core antigen only versus 5.0% (95% CI 3.0%-7.0%) in 1,284 patients who also had anti-HBs. Anti-HBs reduced reactivation risk with a pooled OR of 0.21 (95% CI 0.14-0.32) versus patients with antibody to hepatitis B core antigen only. Similar results were found when limiting the analysis to rituximab chemotherapy (OR = 0.19, 95% CI 0.11-0.32) and lymphoma (OR = 0.18, 95% CI 0.11-0.28).

conclusionIn patients with resolved HBV receiving chemotherapy for hematological malignancies without antiviral prophylaxis, anti-HBs positivity is associated with a decreased risk of reactivation; HBV screening in this patient population should include the routine use of anti-HBs, and those who are anti-HBs-negative should receive antiviral prophylaxis. Future studies should examine the effect of anti-HBs serum titers, the potential role for booster vaccinations, and antiviral prophylaxis prior to chemotherapy in this patient population. (Hepatology 2017;66:379-388).

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsAntiviral AgentsFemaleGuanineHematologic NeoplasmsHepatitis B AntibodiesHepatitis B, ChronicHepatitis B Surface AntigensHumansMalePrognosisRisk AssessmentTreatment OutcomeVirus ActivationAntiviral AgentsentecavirGuanineHepatitis B AntibodiesHepatitis B Surface Antigens

Identifiers

PMID28128861
PMCPMC6485929
OpenAlexW2582667894

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.