Observational studyBMJ open2020
Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab.
Observational study in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Hepatitis B Screening, Antiviral Prophylaxis, and Reactivation Risk in Rituximab-Treated Patients: A 17-Year Population-Based Cohort Study Highlighting Current Practices and Gaps.Digestive diseases and sciences · 2026Article
- Article
- Delayed Hepatitis B Virus Reactivation at 33 Months after the Completion of Rituximab-based Chemotherapy.Internal medicine (Tokyo, Japan) · 2025Article
- Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2023Article
- Liver failure from delayed hepatitis B reactivation in anti-HBc-positive patient following rituximab for B-cell lymphoma.BMJ case reports · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in light of recommendations.
designRetrospective, observational study.
settingSingle, tertiary care centre in the USA.
participantsPatients receiving rituximab from January 2005 to December 2017. PRIMARY OUTCOME: Trends of hepatitis B screening prior to initiation of rituximab. SECONDARY OUTCOME: Results of hepatitis B screening, use of preventive NA therapy and HBr incidence.
resultsOver 13 years, 2219 patients received rituximab. Screening, with at least hepatitis B core antibody (anti-HBc) prior to the first dose of rituximab, improved from 20% to 97%. Because only 4.5% of patients had a positive anti-HBc, the overall HBr incidence was very low (0.42%). In susceptible patients, the incidence of HBr was 8%. In at-risk patients given preventive NA, 96% remained free of HBr. However, only 23% received a preventive NA and no temporal improvement in compliance was seen. Of those with HBr, 87.5% were hepatitis B surface antigen (HbsAg-)/anti-HBc+.
conclusionsIn those treated with rituximab, we demonstrated near-universal anti-HBc screening. Screening unlinked to preventive NA use, in those who are anti-HBc+, is ineffective in reducing HBr. HBr has a high fatality rate. The majority of cases occurred in those who were HBsAg negative. Efforts are needed to educate providers who use rituximab not only to screen for anti-HBc, but to provide preventive NA to those who test positive.
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