Management strategy in aplastic anemia patients with HBV infection following intensive immunosuppressive therapy in Chinese cohort: prophylactic antiviral therapy may not be necessary with close monitoring

PURPOSE: Acquired aplastic anemia (AA) results from bone marrow failure, and intensive immunosuppressive therapy (IST) is a standard treatment for AA. However, the elimination of lymphocytes may lead to the reactivation of hepatitis B virus (HBV) in patients with HBV infection, and whether to administer antiviral drugs for prevention remains uncertain. METHODS: From May 2014 to July 2023, 137 AA patients who were treated with antithymocyte globulin plus Cyclosporin A were divided into three groups according to their HBV serologic status to estimate their safety and efficacy, as well as HBV reactivation. RESULTS: = 0.202) did not affect all-cause mortality. CONCLUSION: Overall, AA patients with chronic HBV infection need to receive prophylactic antiviral drugs during IST, while stringent surveillance methods are necessary for patients with resolved HBV infection.