title: [Hepatitis B reactivation following immunosuppressive therapy  and screening adherence: a neglected problem?].
abstract: BACKGROUND
  Current guidelines of the "Centers for Disease Control and Prevention [CDC]" recommend routine screening for Hepatitis B before cytotoxic or immunosuppressive therapies are initiated. The national German guideline "Prophylaxis, diagnosis and therapy of hepatitis B virus infection" is in line with the CDC recommendations and underscores general HBV screening before immunosuppression is induced. However, screening adherence and acceptance of these guidelines vary in different oncological specialities. To assess the HBV screening adherence a retrospective study was performed.
  
  
  METHODS
  Data of 140 patients were analyzed retrospectively. 37 case-records did not meet inclusion criteria. Patients diagnosed with breast-cancer (n = 43) and Hodgkin's disease (n = 14) requiring chemotherapy were included, as well as patients receiving allogenic stem cell transplantation (SCTx) therapy (n = 22) or transarterial chemoembolization (TACE) therapy of the liver (n = 24). All included case-records were reviewed regarding HBV and HCV serology.
  
  
  RESULTS
  In the TACE group three patients were screened for HBsAg. Four patients with breast cancer and five patients in the Hodgkin disease group were screened for HBsAg. In contrast, screening adherence was 100 % in the group of patients receiving allogenic stem cell transplantation therapy (n = 22).
  
  
  CONCLUSIONS
  Apart from patients with allogenic stem cell transplantation, only some patients receiving immunosuppressive therapies had been screened for HBV infection. Our data indicate that standardized checklists may improve HBV screening previous to immunosuppressive therapies. These clinical structures have led to an almost optimal screening adherence in the high-risk group of allogenic SCTx patients.
authors: Medizinische Klinik II / Sektion Klinische Infektiologie, Universitätsklinik Freiburg i.Br, Deutschland. Johannes.borde@web.de
authors: J P
authors: JP
authors: Borde
authors: W V
authors: WV
authors: Kern
authors: J
authors: J
authors: Becker
authors: H
authors: H
authors: Bertz
authors: J
authors: J
authors: Hübner
authors: W B
authors: WB
authors: Offensperger
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000276:immunology; D057189:Checklist / Q000592:standards; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D054242:Emigrants and Immigrants; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006509:Hepatitis B / Q000175:diagnosis* / Q000276:immunology / Q000821:virology*; D006515:Hepatitis B virus / Q000502:physiology*; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D010349:Patient Compliance; D012189:Retrospective Studies; D012307:Risk Factors; D014775:Virus Activation / Q000276:immunology*
chemical_list: D007166:Immunosuppressive Agents