Key Recommendations
➤ Screen all patients prior to starting systemic anticancer therapy with
three tests: hepatitis B surface antigen (HBsAg), hepatitis B core antibody
(anti-HBc, total Ig or IgG), and antibody to hepatitis B surface antigen
(anti-HBs).
➤ Patients with positive HBsAg or positive anti-HBc may require additional
monitoring and/or antiviral treatment.
Diagnosis
➤ All patients with cancer anticipating systemic anticancer therapy should
be tested for HBV by three tests prior to, or at the beginning of, systemic
anticancer therapy:
• hepatitis B surface antigen (HBsAg )
• hepatitis B core antibody (anti-HBc) total immunoglobulin (Ig ) or IgG
• antibody to hepatitis B surface antigen (anti-HBs)
Note: Anticancer therapy should not be delayed for the results of these screening tests.
Findings of chronic HBV (HBsAg-positive) or past HBV (HBsAg-negative and anti-HBc-
positive with either negative or positive anti-HBs) infection require reactivation risk assessment.
(Strong recommendation; EB-B)
