Steadily decline of HBV DNA load under NAs in lymphoma patients and higher level of qAnti-HBc predict HBV reactivation

Abstract

Abstract Background Patients with lymphoma and hepatitis B virus infection need to be treated with both chemotherapy and nucleotide analogues (NAs) therapy. However, the dynamic change of HBV DNA with the increase of chemotherapy cycles is lacking. It is unknown that whether HBV replication markers: quantitative hepatitis B core antibody (qAnti-HBc), HBV RNA, and hepatitis B virus core-related antigen (HBcrAg) are also sensitive to predict HBV reactivation (HBVr). Methods From 29th June 2010 to 6th December 2021, clinical data and serial serum samples were collected from patients with diffuse large B lymphoma and HBV infection. Serum HBV DNA load (real time fluorescent quantitative PCR), qAnti-HBc (developed chemiluminescent particle immunoassay), HBV RNA (simultaneous amplification testing method based on real-time fluorescence detection), and HBcrAg (Lumipulse G HBcrAg assay) were tested and actors related to HBV DNA reactivation were analyzed. Results Under the NAs, load of HBV DNA in 69 HBsAg + lymphoma patients declined from 3.15 (2.13–4.73) lg IU/ml at baseline to 1.00 (1.00-1.75) lg IU/ml at the end of chemotherapy, and further declined to 1.00 (1.00-1.04) lg IU/ml at the end of 24-month follow-up. Serum qAnti-HBc level decreased gradually during chemotherapy in HBsAg + lymphoma patients (F = 7.090, p = 0.009). Serum HBV RNA and HBcrAg levels stayed stabled. Multivariate analysis revealed that a higher level of qAnti-HBc (1.97 ± 1.20 vs. 1.12 ± 0.84 lg IU/ml, OR = 8.367, [95% CI:1.439–48.645], p = 0.018) and a higher level of HBV RNA (1.00 ± 1.13 vs. 0.37 ± 0.80 lg copies/ml, OR = 3.654, [95% CI:1.208–11.048], p = 0.022) were related to HBVr in HBsAg-/anti-HBc + lymphoma patients. Conclusions The HBV DNA load declined by NAs under chemotherapy in lymphoma patients. In HBsAg-/anti-HBc + lymphoma patients, higher level of baseline serum qAnti-HBc and HBV RNA predict the HBVr during chemotherapy.