乙型肝炎病毒（HBV）再激活是慢性乙型肝炎患者细胞毒性化疗的公认并发症。然而，由于免疫检查点抑制剂（ICIs）被排除在临床试验之外，乙型肝炎病毒再激活的风险仍然不确定。本研究旨在评估接受 ICI 治疗的癌症患者 HBV 再激活的发生率，探讨相关危险因素。这项回顾性研究纳入了乙型肝炎表面抗原 (HBsAg) 检测呈阳性的癌症患者。主要终点是 HBV 再激活的发生率，而次要终点是 ICI 治疗期间肝脏不良事件的发生率。在 162 名符合条件的患者中（中位年龄 59 岁；85.8% 为男性），HBV 再激活发生率为 4.3%，中位数为 13治疗开始后几周。基线时，78 名患者的 HBV DNA 检测不到； 88 名患者接受了抗病毒预防治疗，74 名患者则没有。 HBsAg 阳性个体的再激活率为 3.5%，乙型肝炎核心抗体 (HBcAb) 阳性个体的再激活率为 10%，总体率为 4.3%。接受预防治疗的比例为 1.1%，未接受预防治疗的比例为 8.1%。 22 名患者患有 3-4 级肝炎，25 名患者检测出 HBsAg 阴性但 HBcAb 阳性。没有发生与乙型肝炎相关的死亡事件。缺乏抗病毒治疗是 HBV 再激活的一个重要危险因素。我们的研究强调了接受 ICI 治疗的癌症患者中 HBV 再激活的风险，尤其是那些缺乏抗病毒预防的患者。定期 HBV DNA 检测和抗病毒预防是 HBV 再激活的重要预防措施。这些发现强调了监测接受 ICI 的患者的 HBV 状态的重要性。© 作者 2024。由牛津大学出版社出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Hepatitis B virus (HBV) reactivation is a recognized complication of cytotoxic chemotherapy in patients with chronic hepatitis B. However, the risk of HBV reactivation with immune checkpoint inhibitors (ICIs) remains uncertain due to their exclusion from clinical trials. This study aimed to assess the incidence of HBV reactivation in patients with cancer undergoing ICI therapy, exploring associated risk factors.This retrospective study included patients with cancer who tested positive for hepatitis B surface antigen (HBsAg). The primary endpoint was incidence of HBV reactivation, whereas the secondary endpoint was occurrence of hepatic adverse events during ICI therapy.Among the 162 eligible patients (median age 59 years; 85.8% men), HBV reactivation occurred in 4.3% at a median of 13 weeks post-treatment initiation. At baseline, HBV DNA was undetectable in 78 patients; 88 received antiviral prophylaxis, while 74 patients did not. Reactivation rates were 3.5% in HBsAg-positive and 10% in hepatitis B core antibody (HBcAb)-positive individuals, with an overall rate of 4.3%. These rates were 1.1% with prophylaxis and 8.1% without. Twenty-two patients had grade 3-4 hepatitis, and 25 tested HBsAg-negative but HBcAb-positive. No HBV-related fatalities occurred. The absence of antiviral treatment was a significant risk factor for HBV reactivation.Our study underscores the risk of HBV reactivation in patients with cancer undergoing ICI therapy, especially among those lacking antiviral prophylaxis. Regular HBV DNA testing and antiviral prophylaxis are crucial preventive measures for HBV reactivation. These findings emphasize the importance of monitoring HBV status in patients receiving ICIs.© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.