Antiviral prophylaxis for hepatitis B virus reactivation in T‐cell lymphoma patients with resolved hepatitis B virus infection

Hepatitis B virus (HBV) reactivation can lead to liver dysfunction, potentially disrupting antitumor treatment in patients with malignancies. The role of anti-HBV prophylaxis in preventing HBV reactivation in T-cell lymphoma (TCL) patients with resolved HBV infection remains unclear. We retrospectively included TCL patients with resolved HBV infection (hepatitis B surface antigen negative and HBV core antibody positive) who received anti-lymphoma treatment at Sun Yat-sen University Cancer Center between March 2004 and February 2024. Patients were categorized into the prophylaxis and non-prophylaxis groups based on whether they received prophylactic anti-HBV treatment. Propensity score matching (PSM) with a 1:1 ratio was conducted to balance the differences in baseline characteristics between the two groups. The primary endpoint was the HBV reactivation rate. A total of 174 eligible patients were included in the PSM cohort. After matching, no significant differences were observed in baseline characteristics between the prophylaxis group (n = 87) and non-prophylaxis group (n = 87). With a median follow-up of 24.0 months (IQR, 11.0-38.5), the HBV reactivation rate was 0% (0/87) and 5.7% (5/87) (p = .059) in the prophylaxis group and non-prophylaxis group, respectively. Patients in the non-prophylaxis group showed a higher cumulative HBV reactivation rate than those in the prophylaxis group (p = .025). All the five patients who experienced HBV reactivation had encountered delays or discontinuation in their anti-lymphoma therapy. These findings show that TCL patients with resolved HBV infection who received anti-HBV prophylaxis had a lower rate of HBV reactivation, indicating the potential benefit of anti-HBV prophylaxis treatment in this group of patients.