Journal
IMMUNOTHERAPY
Volume 13, Issue 5, Pages 409-418Publisher
FUTURE MEDICINE LTD
DOI: 10.2217/imt-2020-0273
Keywords
HBV; HCV; hepatitis B virus; hepatitis C virus; ICI; immune checkpoint inhibitor; immunosuppressive agent; immune-related adverse event; irAE; liver immunology; viral reactivation
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Immune checkpoint inhibitors (ICIs) appear to be relatively safe in patients with chronic HBV/HCV infection, potentially playing a role in viral clearance. Close clinical and biochemical monitoring is recommended during ICI treatment, with antiviral therapy initiated when necessary.
More patients with chronic hepatitis B and C infection are being exposed to immune checkpoint inhibitors (ICIs), but the safety and efficacy of ICIs in patients with chronic viral hepatitis are still poorly described. To explore this interaction, we identified eight studies of cancer patients with viral hepatitis treated with one or more ICIs, formally assessed tumor responses and safety by grading liver dysfunction. ICIs appear to be relatively safe in HBV/HCV-infected patients, and hepatitis related to viral reactivation is rare. In some patients, viral load regressed during ICI treatment, so immune checkpoints may play a role in viral clearance. HBV/HCV do not appear to be a contraindication to ICIs, although careful clinical and biochemical follow-up is recommended and, whenever necessary, antiviral therapy commenced.
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