Wei-Yuan ChangYen-Cheng ChiuFang-Wei ChiuYao-Chun HsuTai-Chung TsengPin-Nan ChengSheng-Shun YangChun-Jen LiuTung-Hung SuHung-Chih YangChen-Hua LiuPei-Jer ChenDing-Shinn ChenJia-Horng Kao2026-01-302026-01-302020-05-1210.1093/infdis/jiaa256https://scholars.csmu.edu.tw/handle/123456789/4059<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Prophylaxis with nucleos(t)ide analogue (NA) is recommended to prevent hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)–positive patients receiving rituximab-based B-cell depletion therapy. However, little is known about the risk of clinical relapse after withdrawal of NA.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We retrospectively analyzed 77 noncirrhotic HBsAg carriers with hematological cancer who received rituximab-containing chemotherapy. All of them received either prophylactic entecavir or tenofovir therapy. The risk of clinical relapse and hepatic decompensation after cessation of NA was explored.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Clinical relapse and hepatic decompensation developed in 25 (32.5 %) and 11 (14.3 %) of the patients, respectively, and 2 patients died of hepatic decompensation. Most of the hepatic events occurred within 1 year (20 of 25; 80.0%) after stopping NA. A higher pretreatment viral load (≥2000 vs &amp;lt;2000 IU/mL) was associated with increased risks of clinical relapse (hazard ratio, 3.47; 95% confidence interval, 1.56–7.73) and hepatic decompensation (9.91; 2.14–45.92). Of 51 patients with pretreatment viral load &amp;lt;2000 IU/mL, clinical relapse occurred in 10 (19.6 %) and hepatic decompensation in 2 (3.9%).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Pretreatment HBV DNA ≥2000 IU/mL is associated with increased risk of liver-related disease after cessation of prophylactic NA therapy in patients who received rituximab-containing chemotherapy.</jats:p> </jats:sec>[SDGs]SDG3journal-article