P32: Hepatitis B screening prior to chemotherapy initiation in a tertiary care center in Québec, Canada
Notice bibliographique
Résumé
Reactivation of hepatitis B virus (HBV) during or after chemotherapy is a serious complication of cancer treatment. Worldwide, hepatology societies suggest that clinicians should screen patients for HBV before starting immunosuppressive therapy. Previous research has shown that the rate of HBV reactivation in chronic HBV patients receiving chemotherapy is drastically reduced with the use of a nucleoside analogue. However, limited data exist in Canada about prevalence of HBV screening prior to chemotherapy. We aimed to determine the rate of HBV screening before chemotherapy in our institution. We retrospectively reviewed 784 case files from adult patients starting a first round of intravenous chemotherapy. In order to meet our statistical power estimates, all 2011 cases and a series of the most recent 2010 cases were reviewed. We collected information about chemotherapy type, the medical condition that required treatment, HBV serology and reactivation rate. Screening was considered as satisfactory when any combination of HBV serologic markers had been measured within 12 months of first day of chemotherapy. Of the 784 charts reviewed, 120 (15.3%; CI 95%: 12.8–17.8%) patients were considered to have been satisfactorily screened for HBV. A screening strategy using HBsAg and anti-HBc testing was performed in 103 (13.1%; CI 95%: 10.7–15.5%) patients. Ninety-three (11.9%) patients received rituximab-based chemotherapy. Of this group, 38 (40.9%; CI 95%: 30.9–50.9%) patients underwent satisfactory pre-emptive HBV screening. Statistical analysis showed a significantly higher (p < 0.0001) screening rate in patients receiving rituximab-based therapy compared to other chemotherapy treatments. Only 3 (0.4%) patients had positive HBsAg serology. Of these patients, none received a nucleoside analogue for prophylaxis and one patient, who received rituximab-based therapy, experienced HBV reactivation. In our institution, HBV serology was available in <20% of patients starting chemotherapy and clinicians are more likely to order HBV serology for patients starting rituximab-based chemotherapy. Although our sample size is relatively limited, our data clearly suggest that clinicians are potentially ill-informed about the risks and consequences of HBV reactivation during chemotherapy. Therefore, this study reinforces the need to inform physicians about the importance of pre-emptive HBV screening prior to chemotherapy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».