ArticleJournal for immunotherapy of cancer2020
Risk of HBV reactivation in patients with immune checkpoint inhibitor-treated unresectable hepatocellular carcinoma.
Article in Journal for immunotherapy of cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 7 of them syntheses that pooled it.
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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
56 citing papers in PubMed, 7 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- First-line immunotherapy for advanced hepatocellular carcinoma: a network meta-analysis of randomized trials with overall and HBV/HCV-stratified efficacy and safety.Frontiers in immunology · 2026Pooled it
- Hepatitis B reactivation in cancer patients receiving immune checkpoint inhibitors: a systematic review and meta-analysis.Infectious diseases of poverty · 2023Pooled it
- Hepatitis B virus reactivation in patients undergoing immune checkpoint inhibition: systematic review with meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Clinical and molecular hepatology · 2022Guideline
- APASL clinical practice guideline on hepatitis B reactivation related to the use of immunosuppressive therapy.Hepatology international · 2021Guideline
- Cancer immunotherapy in special challenging populations: recommendations of the Advisory Committee of Spanish Melanoma Group (GEM).Journal for immunotherapy of cancer · 2021Guideline
- The Efficacy and Safety of Anlotinib Combination Therapy for Advanced Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis.Cancer control : journal of the Moffitt Cancer CenterPooled it
- Immunotherapy for virus-related hepatocellular carcinoma: recent progress and future directions.Annals of medicine · 2026Review
- Nivolumab Induced Reactivation of Hepatitis B in a Patient with Metastatic Gastric Adenocarcinoma-A Case Report.Reports (MDPI) · 2026Article
- Safety of Immune Checkpoint Inhibitors in Hepatitis B Virus-Positive Cancer Patients: A Multicenter Retrospective Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- HBV reactivation during immunotherapy for hepatocellular carcinoma: risk factors and clinical management.Frontiers in immunology · 2026Review
- Virus-driven remodeling of the immune microenvironment and response to immune checkpoint inhibitors: the infection- immunity-cancer crosstalk.Frontiers in immunology · 2026Review
- Baseline low-level viremia in HBV-related hepatocellular carcinoma: prognostic significance, risk stratification, and clinical implications.Frontiers in immunology · 2026Article
- The immunoecology of occult hepatitis B virus infection: genetic remodeling and the immune-mediated microcosm.Frontiers in immunology · 2026Review
- Diagnosis, clinical assessment, and staging of hepatocellular carcinoma: a Brazilian multidisciplinary consensus.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- Immune checkpoint biology in hepatocellular carcinoma (Review).Oncology letters · 2025Review
- The interplay between hepatitis B virus and antitumor drugs in the treatment of hepatocellular carcinoma.Clinical and experimental medicine · 2025Review
- Neoadjuvant immunotherapy for resectable primary liver cancer (Review).Oncology letters · 2025Review
- Review Article: Liver Transplantation for Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors.Alimentary pharmacology & therapeutics · 2025Review
- HLA-DR⁺ Tumor Cells Show an Association with a Distinct Immune Microenvironment and CD8⁺ T-Cell Exhaustion in HBV-Associated Hepatocellular Carcinoma.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmunotherapy with immune checkpoint inhibitor (ICI) is a promising treatment for unresectable hepatocellular carcinoma (HCC). However, whether ICIs would have the risk of hepatitis B virus (HBV) reactivation and the necessary of nucleos(t)ide analogs (NUCs) prophylaxis are still unclear. We aimed to investigate the role of NUCs prophylaxis in HBV-infected patients who underwent ICIs treatment.
methodsThe study was a retrospective prospective design to review and follow-up consecutive 62 patients with chronic hepatitis B or resolved HBV infection who had received ICIs treatment for the unresectable HCC. Of them, 60 patients with documented baseline serum HBV DNA value were classified into three categories according to the baseline HBV viral load and the status of antiviral therapy before ICI treatment. The clinical status, including tumor response, viral kinetics and liver function, was recorded and investigated.
resultsNo HBV reactivation occurred in the 35 patients with HBV DNA ≤100 IU/mL on NUCs therapy. Of the 19 patients with HBV DNA >100 IU/mL who started NUCs simultaneously with ICI treatment, none encountered HBV reactivation during the immunotherapy. Of the six HBV patients without NUCs treatment, three had a greater than 1 log decrease in HBV viral load, and one maintained his serum HBV DNA in undetectable status during ICI treatment. Eventually, one out of six experienced HBV reactivation after 9 weeks of ICI treatment.
conclusionNo patients on antiviral therapy developed HBV reactivation, and one out of six not receiving antiviral therapy had HBV reactivation. HBV viral load higher than 100 IU/mL is safe and not a contraindication for ICI treatment for HCC, if NUCs can be coadministrated.
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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.