Hepatitis B Virus Screening and Management for Patients with Cancer Prior to Therapy

Publication Date: July 27, 2020

Key Recommendations

Key Recommendations

  • Screen all patients prior to starting systemic anticancer therapy with three tests: hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc, total Ig or IgG), and antibody to hepatitis B surface antigen (anti-HBs).
  • Patients with positive HBsAg or positive anti-HBc may require additional monitoring and/or antiviral treatment.

Diagnosis

All patients with cancer anticipating systemic anticancer therapy should be tested for HBV by three tests prior to, or at the beginning of, systemic anticancer therapy:
  • hepatitis B surface antigen (HBsAg)
  • hepatitis B core antibody (anti-HBc) total immunoglobulin (Ig) or IgG
  • antibody to hepatitis B surface antigen (anti-HBs)
(EB, S, B)
Note: Anticancer therapy should not be delayed for the results of these screening tests. Findings of chronic HBV (HBsAg-positive) or past HBV (HBsAg-negative and anti-HBc-positive with either negative or positive anti-HBs) infection require reactivation risk assessment.
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Treatment

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