The occurrence of immune-related adverse events is an independent risk factor both for serum HBsAg increase and HBV reactivation in HBsAg-positive cancer patients receiving PD-1 inhibitor combinational therapy

• DOI: 10.3389/fimmu.2024.1330644
• Publication Date: 2024-03-15T08:54:46Z
• Authors: Yingfu Zeng; Jiwei Huang; Jiahui Pang; Shufang Pan; Yuankai Wu; Yusheng Jie; Xinhua Li; Yutian Chong
• Keywords: Hepatitis B

Background Previous studies have suggested the potential of PD-1/PD-L1 inhibitors in treatment chronic HBV infection. However, since phase III clinical trials not yet been announced, additional insights may be obtained by observing changes serum hepatitis B surface antigen (HBsAg) and HBV-DNA levels cancer patients undergoing PD-1 inhibitor therapy. Objective To explore effects combinational therapy on HBsAg levels, investigate incidence loss, reactivation (HBVr), immune-related adverse events (irAEs), identify risk factors associated with significant fluctuations HBVr. Methods A retrospective study including 1195 HBsAg-positive who received between July 2019 June 2023 was conducted, 180 were enrolled this study. Serum before after administration compared across different subgroups. The Pearson χ 2 or Fisher exact test performed to relationships categorical variables. Univariable multivariable analysis Results With concurrent use antiviral agents, decreased (Z=-3.966, P < 0.0001) 129 increased (t=-2.047, P=0.043) 51 patients. Additionally, 7 (3.89%) achieved loss. Virus replication suppressed most When divided into subgroups, decreases discovered lower baseline group (Z=-2.277, P=0.023), HBeAg-seronegative (Z=-2.200, P=0.028), non-irAEs occurrence (Z=-2.007, P=0.045) liver (Z=-1.987, P=0.047). Of note, 11 36 experienced HBVr (6.11%) irAEs (20%), respectively, which could lead discontinuation delayed inhibitors. After analysis, HBeAg-seropositive (OR, 7.236 [95% CI, 1.757-29.793], P=0.01) 4.077 1.252-13.273], P=0.02) identified as independent for increase, 5.560 only factor Conclusion combined nucleos(t)ide analogues (NAs) exert therapeutic infection attention also should paid elevation HBVr,