2288. Adherence to Hepatitis B Screening and Treatment Guidelines in Oncology Patients Starting Anti-CD20 Therapy. (26th November 2018)

• Record Type: Journal Article
• Authors: Govind, Anusha; L'Etoile, Nathan; Fratamico, Roberto; Filicko-O'Hara, Joanne; DeSimone, Joseph
• Is Part Of: Open forum infectious diseases. Volume 5(2018)Supplement 1
• Page Start: S678
• Page End: S678
• Publication Date: 2018-11-26
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy210.1941
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Hepatitis B virus (HBV) reactivation is a common complication in the treatment of oncology patients when using anti-CD20 monoclonal antibodies (MABs) such as rituximab, obinituzumab, and ofatumumab. In such patients, the reaction of HBV is seen in up to 70% who are HBV DNA positive. Antiviral therapy in high-risk patients has been shown to improve outcomes. Methods: This retrospective review evaluated patients at Thomas Jefferson University Hospital who received rituximab, obinituzumab, or ofatumumab as a component of hematologic malignancy therapy between 2013 and 2016. We determined the number of patients who had appropriate HBV testing prior to therapy, the number who received appropriate antiviral therapy, and the number who developed reactivation of HBV and their outcomes. Results: 402 patients received one of the above anti-CD20 MABs between November 2013 and December 2016. Of these 402 patients, 52 (13.4%) did not have either HBsAg or HBcAb performed prior to anti-CD20 therapy. 39 (9.7%) patients had positive HBsAg or HBcAb prior to therapy. Of these 39 highrisk patients, only 16/39 (41.3%) were placed on appropriate antiviral therapy. Two of the 39 high-risk patients (5.1%), who were not started on antiviral therapy, developed HBV reactivation as a complication of anti-CD20 MAB therapy. Conclusion: A significant number of patients were not appropriately screened with HBV markers prior to anti-CD20 therapy for hematologic malignancies at our institution. In addition, less than half of highrisk HBV patients received appropriate antiviral therapy. System-wide changes are anticipated to improve this process at our institution. Disclosures: All authors: No reported disclosures.